| Comparison of adenosine and high-dose dipyridamole both combined with low-level exercise stress for 99Tcm-MIBI SPET myocardial perfusion imaging. | |
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MedLine Citation:
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PMID: 8778644 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Intravenously administered adenosine and high-dose dipyridamole, both combined with low-level exercise stress, were compared in a head-to-head fashion using 99Tcm-methoxyisobutyl isonitrile (99Tcm-MIBI) single photo emission tomography (SPET) myocardial perfusion imaging. Thirty-nine consecutive patients who had undergone coronary arteriography underwent 99Tcm-MIBI (740 Mbq) SPET after dipyridamole (0.84 mg kg-1) and after adenosine (0.84 mg kg-1), both combined with low-level exercise (30 W load), and under resting conditions. Our results demonstrate that adenosine and dipyridamole combined with exercise have comparable haemodynamic effects, with a low incidence of side-effects. The time of recovery from the stress protocol was not significantly different: adenosine, 5.7 +/- 3.9 min; dipyridamole, 6.6 +/- 4.9 min. However, aminophylline was significantly (P < 0.05) more often administered to reverse side-effects using the dipyridamole protocol (36% of patients) compared with the adenosine protocol (8% of patients). The results of 99Tcm-MIBI SPET imaging were highly concordant and demonstrated a high diagnostic accuracy for identifying coronary artery disease (CAD). The sensitivity was 90% (95% confidence intervals 79-100%) with adenosine SPET and 93% (95% confidence intervals 84-100%) with dipyridamole SPET for identifying patients with CAD (i.e. luminal stenosis > 50%); their specificities were both 100% (95% confidence intervals 66-100%). The sensitivity of identifying angiographically diseased vessels was 81% (95% confidence intervals 70-92%) using adenosine SPET and 85% (95% confidence intervals 75-95%) using dipyridamole; the specificity for both stress modalities was 94% (95% confidence intervals 89-100%). The combination of exercise with adenosine and high-dose dipyridamole appears to be a feasible and safe method to alleviate some of the undesirable A1-receptor-mediated side-effects of adenosine. The choice of the pharmacological stress will depend on local expertise and availability. |
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Authors:
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M J Cramer; J F Verzijlbergen; E E van der Wall; P H Vermeersch; M G Niemeyer; A H Zwinderman; C A Ascoop; E K Pauwels |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Nuclear medicine communications Volume: 17 ISSN: 0143-3636 ISO Abbreviation: Nucl Med Commun Publication Date: 1996 Feb |
Date Detail:
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Created Date: 1996-09-19 Completed Date: 1996-09-19 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8201017 Medline TA: Nucl Med Commun Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 97-104 Citation Subset: IM |
Affiliation:
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Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenosine
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administration & dosage,
adverse effects,
diagnostic use* Adult Aged Clinical Protocols Coronary Disease / radionuclide imaging Dipyridamole / administration & dosage, adverse effects, diagnostic use* Exercise Test / adverse effects, methods Female Heart / radionuclide imaging* Hemodynamics / drug effects Humans Injections, Intravenous Male Middle Aged Safety Technetium Tc 99m Sestamibi / administration & dosage, diagnostic use* Tomography, Emission-Computed, Single-Photon / methods* Vasodilator Agents / administration & dosage, adverse effects, diagnostic use* |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 109581-73-9/Technetium Tc 99m Sestamibi; 58-32-2/Dipyridamole; 58-61-7/Adenosine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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