Alterations in myocardial perfusion during exercise after isosorbide dinitrate infusion in patients with coronary disease: assessment by thallium-201 scintigraphy.
Alterations in myocardial perfusion during exercise after isosorbide dinitrate infusion in patients with coronary disease: assessment by thallium-201 scintigraphy.
复制标题
冠心病患者输注硝酸异山梨酯后运动过程中心肌灌注的变化：铊201闪烁扫描法评估。
DOI：
10.1016/0002-8703(86)90058-x
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发表时间：
1986
影响因子：
4.8
通讯作者：
S. Yasui
中科院分区：
文献类型：
--
作者：
I. Tono;S. Satoh;T. Kanaya;A. Komatani;K. Takahashi;K. Tsuiki;S. Yasui
应用运动铊-201（TI-201）心肌显像技术，观察静脉注射硝酸异山梨酯（ISDN）对冠心病患者心肌灌注的影响。最初进行对照研究以评估局部心肌灌注率。左室心肌分为前、侧、尖、下、后、隔6段。根据TI-201相对分布的初始摄取指数（IUI）和TI-201洗脱的再分布指数（RDI）来表征节段性心肌灌注。根据17例冠状动脉正常者的资料，确定IUI和RDI的正常范围，以IUI ≤ 84%，RDI ≥ 1.12为异常。根据IUI和RDI将每个节段分为三种类型：A型= IUI ≥ 84%，RDI ≥ 1.12; B型= IUI ≥ 84%，RDI < 1.12; C型= IUI > 84%，RDI < 1.12。ISDN以0.1 mg/kg/hr的剂量给药，然后使用与对照期相同的方案重复跑步机测试，持续相同的运动时间。ISDN组A型节段IUI和RDI明显改善，B、C型节段无明显变化。研究还表明，多支血管病变的A型节段IUI和RDI的改善不如单支血管病变明显。我们的研究结果表明，ISDN特别改善缺血心肌的心肌灌注，改善程度受心肌存活和冠状动脉疾病的严重程度的影响。
We studied the effect of intravenous isosorbide dinitrate (ISDN) on myocardial perfusion of patients with coronary artery disease, by using exercise thallium-201 (TI-201) myocardial scintigraphy. A control study was conducted initially to assess regional myocardial perfusion rate. Left ventricular myocardium was divided into six parts: anterior, lateral, apical, inferior, posterior, and septal segments. The segmental myocardial perfusion was characterized according to TI-201 initial uptake index (IUI) of relative distribution and redistribution index (RDI) of TI-201 washout. The normal limit of IUI and RDI was established from the data of 17 persons with normal coronary arteries, and then the IUI ≤ 84% and the RDI ≥ 1.12 was defined as abnormal. Based on IUI and RDI, each segment was characterized into three types: A type = IUI ≦ 84%, RDI ≧ 1.12; B type = IUI ≦ 84%, RDI < 1.12; and C type = IUI > 84%, RDI < 1.12. ISDN was given as a dose of 0.1 mg/kg/hr, and then treadmill testing was repeated for the same duration of exercise time using the same protocol as in the control period. The segments of A type showed a significant improvement in IUI and RDI after receiving ISDN infusion, while the B and C type segments showed no change. It was also shown that the improvement of IUI and RDI of the A type segments was not as marked in multivessel disease as in cases of single-vessel disease. The results of our study suggest that ISDN particularly improves myocardial perfusion in ischemic myocardium, and the degree of improvement is influenced by myocardial viability and the severity of coronary artery disease.