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静脉注射腺素输注对心肌 perfusion 和功能的影响. 血液动力学/血管学和光阴学研究

J D Ogilby¹, A S Iskandrian, W J Untereker

¹Philadelphia Heart Institute, Presbyterian Medical Center, PA 19104.

|September 1, 1992

概括

在大多数冠状动脉疾病 (CAD) 患者中,腺素压力测试显示了输液缺陷,但缩功能保持稳定. 这表明透支功能障碍在CAD诊断的腺注射期间有助于血液动力学变化.

科学领域:

心脏病学心脏病学
核医学就是核医学.
诊断成像诊断成像诊断成像

背景情况:

用腺或二皮里达摩尔进行心肌输液成像 (MPI) 是诊断冠状动脉疾病 (CAD) 的标准.
perfusion 异常可能源于不同的流量反应或冠状动脉盗窃现象.
这项研究调查了201Tl输液模式与静脉注射腺素输注期间的血液动力学/血管学变化之间的相关性.

研究的目的:

为了检查201Tl输液模式和静脉注射腺素输液期间的血液动力学/血管学变化之间的关系.
评估201T1MPI在CAD的腺应激期间的诊断准确性.
了解CAD患者输液异常和血液动力学反应背后的机制.

主要方法:

33名CAD患者和12名对照在腺输注期间同时接受了血液动力学,冠状动脉图,左心室图和201Tl SPECT成像.
腺素被静脉注射在140微克/千克/分钟,持续6分钟.
对冠状动脉狭窄和左心室功能进行了定量分析.

主要成果:

201T1 MPI在CAD检测方面表现出94%的灵敏度和100%的特异性.
氨酸输注引起了显著的血液动力学变化,包括心率增加,心脏输出和肺毛细血管压,系统血管阻力和血压下降.
在CAD患者中,在 perfusion 缺陷 (41% 的段落) 和保留或改善区域壁运动 (8% 的段落) 之间观察到差异.

结论:

腺素应激测试显示,心肌输液缺陷与CAD患者的全球/区域缩功能之间的差异.
扩张性左心室功能障碍可能是导致肺毛细血管压力的增加的原因.
在腺注入期间201Tl MPI是诊断CAD的一种敏感和特定的方法,突出了潜在的扩张功能障碍.

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