A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
The effect of nitroglycerin on myocardial blood flow in various segments characterized by rest-redistribution thallium SPECT
Tekijät: Tadamura E, Mamede M, Kubo S, Toyoda H, Yamamuro M, Iida H, Tamaki N, Nishimura K, Komeda M, Konishi J
Kustantaja: SOC NUCLEAR MEDICINE INC
Julkaisuvuosi: 2003
Journal: Journal of Nuclear Medicine
Tietokannassa oleva lehden nimi: JOURNAL OF NUCLEAR MEDICINE
Lehden akronyymi: J NUCL MED
Vuosikerta: 44
Numero: 5
Aloitussivu: 745
Lopetussivu: 751
Sivujen määrä: 7
ISSN: 0161-5505
Tiivistelmä
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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