A1 Refereed original research article in a scientific journal
The effect of nitroglycerin on myocardial blood flow in various segments characterized by rest-redistribution thallium SPECT
Authors: Tadamura E, Mamede M, Kubo S, Toyoda H, Yamamuro M, Iida H, Tamaki N, Nishimura K, Komeda M, Konishi J
Publisher: SOC NUCLEAR MEDICINE INC
Publication year: 2003
Journal: Journal of Nuclear Medicine
Journal name in source: JOURNAL OF NUCLEAR MEDICINE
Journal acronym: J NUCL MED
Volume: 44
Issue: 5
First page : 745
Last page: 751
Number of pages: 7
ISSN: 0161-5505
Abstract
The use of nitrates is reported to be effective in viability detection in scintigraphic perfusion imaging. The purpose of the study was to evaluate the effect of nitroglycerin (NTG) on myocardial blood flow (MBF) and coronary vascular resistance (CVR) in various segments characterized by rest-redistribution Tl-201 SPECT. Methods: Twenty-three patients with coronary artery disease underwent rest-redistribution Tl-201 SPECT and O-15-labeled water PET at rest and after NTG spray (0.3 mg). In addition, 11 healthy volunteers were also studied using PET. Results: NTG did not change global MBF in the volunteers or in the patients. In segments with normal Tl-201 uptake and in those with a severe irreversible Tl-201 defect, NTG significantly reduced MBF without changing CVR. NTG reduced CVR in segments with a reversible Tl-201 defect (1141 +/- 50 to 114 +/- 29 mm Hg/[mL/min/g], P = 0.004) and in those with a mild-to-moderate irreversible Tl-201 defect (165 +/- 64 to 149 +/- 60 mm Hg/[mL/min/g], P = 0.003), while maintaining MBF. Conclusion: NTG preferentially reduces CVR in the viable myocardium with ischemia. After NTG, tracer uptake in the ischemic myocardium will be relatively increased compared with that in the nonviable and nonischemic myocardium, leading to improvements in viability detection.
The use of nitrates is reported to be effective in viability detection in scintigraphic perfusion imaging. The purpose of the study was to evaluate the effect of nitroglycerin (NTG) on myocardial blood flow (MBF) and coronary vascular resistance (CVR) in various segments characterized by rest-redistribution Tl-201 SPECT. Methods: Twenty-three patients with coronary artery disease underwent rest-redistribution Tl-201 SPECT and O-15-labeled water PET at rest and after NTG spray (0.3 mg). In addition, 11 healthy volunteers were also studied using PET. Results: NTG did not change global MBF in the volunteers or in the patients. In segments with normal Tl-201 uptake and in those with a severe irreversible Tl-201 defect, NTG significantly reduced MBF without changing CVR. NTG reduced CVR in segments with a reversible Tl-201 defect (1141 +/- 50 to 114 +/- 29 mm Hg/[mL/min/g], P = 0.004) and in those with a mild-to-moderate irreversible Tl-201 defect (165 +/- 64 to 149 +/- 60 mm Hg/[mL/min/g], P = 0.003), while maintaining MBF. Conclusion: NTG preferentially reduces CVR in the viable myocardium with ischemia. After NTG, tracer uptake in the ischemic myocardium will be relatively increased compared with that in the nonviable and nonischemic myocardium, leading to improvements in viability detection.
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