Iskandrian A S, Verani M S, Heo J
Philadelphia Heart Institute, Presbyterian Medical Center, Philadelphia, PA 19104, USA.
J Nucl Cardiol. 1994 Jan-Feb;1(1):94-111. doi: 10.1007/BF02940016.
Pharmacologic stress testing may be used in the diagnosis of coronary artery disease and risk assessment. The stress agents may be divided into those that produce primary coronary vasodilation (dipyridamole, adenosine, or adenosine triphosphate) and those that produce secondary vasodilation as a result of increase in myocardial oxygen demand (dobutamine and arbutamine). Assessment of myocardial perfusion and function can be made by single-photon imaging, positron emission tomography, two-dimensional echocardiography, magnetic resonance imaging, and contrast angiography. For assessment of myocardial perfusion, either thallium 201-labeled or technetium-labeled perfusion imaging agents may be used. This article will focus on the mechanisms of action, hemodynamic responses, and results of pharmacologic imaging in detecting coronary artery disease. The use of pharmacologic stress testing in risk assessment will be discussed in a separate article.
药物负荷试验可用于冠状动脉疾病的诊断和风险评估。负荷剂可分为产生原发性冠状动脉扩张的药物（双嘧达莫、腺苷或三磷酸腺苷）和因心肌需氧量增加而产生继发性血管扩张的药物（多巴酚丁胺和阿巴美丁）。可通过单光子成像、正电子发射断层扫描、二维超声心动图、磁共振成像和对比血管造影来评估心肌灌注和功能。对于心肌灌注评估，可使用铊201标记或锝标记的灌注显像剂。本文将重点讨论药物成像在检测冠状动脉疾病中的作用机制、血流动力学反应及结果。药物负荷试验在风险评估中的应用将在另一篇文章中讨论。
