Safety Evaluation and Diagnostic Value of Domestic-made Adenosine in Pharmacological Stress with Myocardial Perfusion Imaging for Coronary Artery Disease
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Objective: To evaluate the safety and diagnostic value of domestic-made adenosine stress test with myocardial perfusion imaging for coronary artery disease.Methods: A total of 51 patients were included in this study.Adenosine was infused.At the end of 3 minute of adenosine infusion.925MBq of 99mTc-MIBI was injected intravenously.SPECT myocardial imaging acquisition was obtained 1-1.5 hour after adenosine infusion.Hemodynamic chang and side effects caused by adenosine infusion were analyzed.By more than half a year follow-up to exclude or diagnosed coronary artery disease,and thus evaluation of adenosine stress myocardial perfusion imaging for diagnosing coronary artery disease.Results: The rate of side effects caused by domestic-made adenosine infusion was 86.3%(44 of 51 patients),but most of the side effects were mild and transient.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of adenosine myocardial perfusion imaging for detection of coronary artery disease was 90.9%,71.4%,88.2%,95.2%,55.6% respectively.Conclusion: Domestic-made adenosine can be safely applied in the stress test during myocardial perfusion imaging,and it is an sensitive method for detecting coronary artery disease.Keywords:
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To analyze the sensitivity and specificity of adenosine stress myocardial perfusion tomographic imaging for the diagnosis of coronary artery disease (CAD).Adenosine was infused intravenously at a rate of 140 microg.kg(-1).min(-1) for 6 minutes. 3 minutes after adenosine infusion, 925 MBq of (99m)Tc-MIBI were injected intravenously. SPECT myocardial imaging acquisition was obtained 1.5 hours after adenosine infusion. If the result was abnormal, rest myocardial perfusion imaging would be performed next day. Coronary angiography was performed in all patients within one week of myocardial imaging.Total 79 cases [(62 +/- 10) years old, 35 men, 44 women] were included in this study. In the 50 cases of CAD patients confirmed by coronary angiography, 44 patients have positive adenosine (99m)Tc-MIBI myocardial perfusion SPECT. Nineteen out of 29 cases without CAD have negative adenosine myocardial perfusion tomographic imaging. The sensitivity and specificity of adenosine myocardial perfusion tomographic imaging for the diagnosis of CAD were 88.0% and 65.5%. The sensitivity of adenosine myocardial perfusion tomographic imaging for diagnosing coronary stenosis in left anterior descending, left circumflex and right coronary artery are 32/40, 21/27 and 31/32. There was no severe adverse side effect during adenosine stress test.Adenosine stress myocardial perfusion tomographic imaging is an useful non-interventional method for detecting coronary artery disease.
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Objective:To assess the diagnostic value of adenosine 99mTc-MIBI myocardial perfusion SPECT in coronary slow flow (CSF) phenomenon.Method:The patients were divided into 3 groups according to their coronary angiography results,including the CSF group,normal coronary flow(NCF) group and coronary artery stenosis group. Coronary flow patterns of the cases were determined by corrected thrombolysis in myocardial infarction (TIMI) frame count(CTFC) method. CAG,resting electrocardiograph(ECG),adenosine stress ECG,rest and adenosine myocardial perfusion SPECT were performed in all patients. Result:The positive rate of CSF in adenosine stress myocardial perfusion SPECT was significantly higher than on adenosine stress ECG and rest ECG(P0.05). The scope and degree of myocardial ischemia on adenosine myocardial perfusion SPECT was coronary artery stenosis group CSFNCF pattern(P0.01). Conclusion:There is a direct relationship between CSF phenomenon and myocardial ischemia. Adenosine myocardial perfusion SPECT is considered as an useful non-interventional method for detecting patient's myocardial ischemia with CSF.
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Objective To assess the sensitivity,specificity and its clinical application of adenosine stress my- ocardial imaging on coronary artery disease(CAD).Methods 53 cases suspiciously diagnosed CAD were per- formed with Adenosine stress myocardial perfusion imaging after resting myocardial perfusion imaging in 24 hours,and the heart rate,blood pressure and clinical symptom during injecting adenosine were recorded.All pa- tients were performed with coronary angiography in the 2 weeks.Results The sensitivity,specificity and accu- racy of adenosine stress myocardial perfusion imaging for detection of CAD were 88.9%,70.6% ,83.0% respec- tively.The positive predictive value and negative predictive value was 86.5% and 75.0%.The sensitivity of sin- gle,two and three coronary artery disease was 78.6%,90% and 100% respectively.There is no severe aeeident during injecting adenosine.Conclusion Adenosine stress myocardial perfusion imaging has a higher sensitivity and specificity in diagnosis of CAD.It can be an important additional method of exercise stress myocardial perfu- sion imaging and deserve to utilize and to spread in the clinic practice.
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objection To assess the accuracy of adenosine 99mTc-MIBI for the diagnosis of coronary artery disease and to evaluate the effect of adenosine 99mTc-MIBI myocardial perfusion SPECT in percutaneous coronary intervention(PCI).Methods Coronary angiography and adenosine 99mTc-MIBI myocardial perfusion SPECT were performed for all patients,After PCI.Adenosine was infused intravenously at a total 840 μg·kg-1 for 6 minutes,and 925MBq 99mTc-MBI was injected intravenously at 3 minutes after adenosine infusion.If the result was abnormal,rest 99mTc-MBI myocardial perfusion SPECT was performed next day.Results There were 134(63.3±14.8)cases with CAD.Adenosine myocardial perfusion imaging was abnormal in 109 cases out of 134 patients with significant coronary artery stenosis,in which 12 patients got PCI.Conclusion Adenosine myocardial perfusion imaging is an accurate method for detecting coronary artery disease and can be used in detecting regional myocardial perfusion abnormalities for patients with PCI.
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Objective To study the exercise test( TET) and to assess the diagnostic value of adenosine stress myocardial perfusion imaging for coronary heart disease( CHD). Methods Simultaneous TET、coronary artery angiography( CAG) and adenosine stress myocardial perfusion imaging examination of 139 cases suspected coronary heart disease were analyzed,and the test results to the CAG as the gold standard for diagnosis of coronary heart disease,compared with TET and adenosine stress myocardial perfusion imaging in the diagnosis of coronary heart disease in terms of sensitivity,accuracy and specificity. Results 139 patients with 84 cases after the CAG patients diagnosed with coronary heart disease. In the CAG data reference,TET compared with adenosine stress myocardial perfusion imaging,the accuracy of the adenosine stress myocardial perfusion imaging( 89. 29%) and specificity( 83. 64%) were superior to TET( accuracy of 69. 05%,specificity 63. 64%). In the diagnosis of severe coronary heart disease,the basic are the same,for virus infection aslar-pacific perspective of coronary heart disease,adenosine stress myocardial perfusion imaging( 60%) is higher than the accuracy of TET( 10%). Conclusion Adenosine stress myocardial perfusion imaging and TET as noninvasive examination method of the coronary heart disease are valuable to the diagnosis of coronary heart disease. The CAG as the control point,TET compared with adenosine stress myocardial perfusion imaging,adenosine stress myocardial perfusion imaging diagnostic performance better.
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Objective To evaluate the accuracy and safety of domestic-made adenosine in 99mTc-methoxyisobutylisonitrle(MIBI)myocardial perfusion SPECT/CT during adenosine stress for the diagnosis of myocardial ischemia.Methods Sixty patients with suspected coronary artery disease underwent adenosine stress and rest myocardial perfusion imaging.Adenosine was infused intravenously at a constant rate of 0.14 mg/kg·min for 6 min.At the end of 3 min,925MBq of 99mTc-MIBI was injected.Results Adenosine stress myocardial perfusion scintigraphy was abnormal in 48 out of the 60 patients.The positive rate was 80%.The frequency of side effects was slight and transient with the incidence of 80%(48/60).Conclusions The domestic-made adenosine in stress myocardial perfusion imaging is safe and sensitive for detecting myocardial ischemia.
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Objective To evaluate the sensitivity,accuracy and specificity of adenosine stress myocardial perfusion tomographic imag-ing in the diagnosis of coronary artery disease(CAD).Methods A total of 132 patients with suspected coronary artery disease were included in the study.Adenosine was infused intravenously at a rate of 140 g/(kg·min)for 6 min.At the end of 3 min after adenosine infusion,925 MBq of 99mTc-MIBI was injected intravenously.In this process,the symptom,blood pressure and heart rate were recorded.SPECT myocardial imaging acquisition was obtained at hour 1.5 after adenosine infusion.If the imaging was abnormal,the resting myocardial perfusion imaging would be obtained at the next day.All patients underwent coronary angiography.Results Of 132 patients,87 patients showed the positive coronary angiography,and 45 negative;85 patients showed SPECT myocardial imaging positive,and 47 negative.The unanimous results detected by two methods were found in 108 patients.The false positive results of myocardial scintigraphy were found in 11 patients,and the false-negative in 13.The sensitivity,specificity and accuracy of adenosine myocardial perfusion tomographic imaging for the diagnosis of CAD were 85.1%(74/87),75.6%(34/45)and 81.8%(108/132).Conclusion Adenosine stress myocardial perfusion tomographic imaging is a useful non-interventional method for detecting coronary artery disease.
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Objective To explore the safety and diagnostic accuracy of adenosine 99 mTc-MIBI myocardial perfusion imaging in patients aged ≥65 years.Methods Ninety-two patients aged ≥65 years underwent adenosine 99 mTc-MIBI myocardial perfusion imaging and coronary angiography(CAG).Side effects caused by adenosine infusion were analyzed.The value of resting electrocardiograph(ECG),adenosine stress ECG and adenosine myocardial perfusion imaging in the diagnosis of coronary artery disease were compared.Results In the senile patients,85.9% had varied kinds of adverse reaction,while no serious adverse reaction occurred.In the 68 cases undergoing positive adenosine 99 m Tc-MIBI myocardial perfusion imaging,46 patients presented with severes coronary artery stenosis,16 with coronary slow flow(CSF)and 6 cases with normal coronary flow confirmed by coronary angiography.The sensitivity of adenosine myocardial perfusion imaging for the diagnosis of coronary stenosis and CSF were 95.8% and 84.2%.The specificity of adenosine myocardial perfusion imaging for diagnosing coronary artery disease was 76.0%.The sensitivity of adenosine myocardial perfusion imaging was significantly higher than that of adenosine stress ECG and resting ECG(P0.05).Conclusions Adenosine 99 mTc-MIBI myocardial perfusion imaging is a safe and useful noninterventional method for detecting coronary artery disease in patients aged ≥65 years.
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Objective To analyze the sensitivity and specificity of adenosine stress myocardial perfusion tomographic imaging for the diagnosis of coronary artery disease(CAD).Methods Adenosine was infused intravenously at a rate of 140μg /(kg·min) for 6 minutes.3 minutes after adenosine infusion,925MBq of 99mTc-MIBI were injected intravenously.SPECT myocardial imaging acquisition was obtained 1 hours after adenosine infusion.If the result was abnormal rest myocardial perfusion imaging would be performed next day.Results The sensitivity and specificity of adenosine myocardial perfusion tomographic imaging for the diagnosis of CAD were 87.0% and 64.2%.The sensitivity of adenosine myocardial perfusion tomographic imaging for diagnosing coronary stenosis in left anterior descending,left circumflex and right coronary artery are 41 /48,27 /33 and 37 /38.There was no severe adverse side effect during adenosine stress test.Conclusion Adenosine stress myocardial perfusion tomographic imaging is an useful non-interventional method for detecting coronary artery disease.
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