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Ribose facilitates thallium-201 redistribution in patients with coronary artery disease
N S Perlmutter1, R A Wilson, D A Angello
1Div. of Cardiology, Oregon Health Sciences Univ., Portland 97201-3098.
Insights
Intravenous ribose, an adenine nucleotide precursor, improved thallium-201 redistribution and enhanced identification of ischemic myocardium in coronary artery disease patients. This finding suggests ribose aids in visualizing heart muscle affected by reduced blood flow.
Area of Science:
- Cardiology
- Nuclear Medicine
- Biochemistry
Background:
- Coronary artery disease (CAD) diagnosis often relies on identifying ischemic myocardium.
- Thallium-201 (201Tl) redistribution imaging is a key diagnostic tool.
- Enhancing the sensitivity of 201Tl imaging for ischemia is clinically significant.
Purpose of the Study:
- To determine if post-ischemic intravenous ribose infusion improves thallium-201 redistribution.
- To assess if ribose enhances the identification of ischemic myocardium in patients with CAD.
Main Methods:
- 17 patients with CAD underwent two exercise 201Tl stress tests.
- Postexercise imaging was followed by either i.v. ribose or saline infusion.
- Additional imaging occurred at 1 and 4 hours postexercise; defects identified by count-profile analysis.
Main Results:
- Significantly more reversible 201Tl defects were identified post-ribose compared to post-saline (p < 0.001).
- This enhancement was observed at both 1 and 4 hours postexercise.
- Coronary arteriogram analysis confirmed defects were in regions supplied by stenosed arteries.
Conclusions:
- Intravenous ribose facilitates 201Tl redistribution in patients with CAD.
- Ribose appears to enhance the identification of ischemic myocardium.
- Ribose may improve the diagnostic accuracy of stress 201Tl imaging for detecting myocardial ischemia.
Abstract:
To investigate whether i.v. infusion of ribose, an adenine nucleotide precursor, postischemia facilitates thallium-201 (201Tl) redistribution and improves identification of ischemic myocardium in patients with coronary artery disease (CAD), 17 patients underwent two exercise 201Tl stress tests, performed 1-2 wk apart. After immediate postexercise planar imaging, patients received either i.v. ribose (3.3 mg/kg/min x 30 min) or saline as a control. Additional imaging was performed 1 and 4 hr postexercise. Reversible defects were identified by count-profile analysis. Significantly more (nearly twice as many) reversible 201Tl defects were identified on the post-ribose images compared to the post-saline (control) images at both 1 and 4 hr postexercise (p less than 0.001). Quantitative analyses of the coronary arteriogram was available in 13 patients and confirmed that the additional reversible defects were in myocardial regions supplied by stenosed arteries. We conclude that ribose appears to facilitate 201Tl redistribution in patients with CAD and enhances identification of ischemic myocardium.