Diagnosis of coronary artery disease by controlled coronary vasodilation with adenosine and thallium-201 scintigraphy in patients unable to exercise (see comments)

Journal Article · Sun Jul 01 04:00:00 EDT 1990 · Circulation; (USA)

DOI:https://doi.org/10.1161/01.CIR.82.1.80· OSTI ID:6867291

Verani, M S; Mahmarian, J J; Hixson, J B; Boyce, T M; Staudacher, R A ^[1]

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1. Baylor College of Medicine, Houston, TX (USA)

Pharmacological coronary vasodilation induced by dipyridamole is often used in association with thallium-201 myocardial scintigraphy to evaluate the presence and prognostic significance of coronary artery disease. Because dipyridamole acts by blocking the cellular uptake of adenosine, we investigated the usefulness of direct intravenous administration of adenosine, a physiological substance with an exceedingly short (less than 2 seconds) plasma half-life, to induce maximal controlled coronary vasodilation in conjunction with 201Tl scintigraphy. We studied 89 patients (44 men and 45 women; mean age, 64 +/- 10 years (SD)) who were unable to perform an exercise test and were referred for evaluation of suspected coronary artery disease. The intravenous infusion of adenosine began at an initial rate of 50 micrograms/kg/min and was increased by stepwise increments every minute to a maximal rate of 140 micrograms/kg/min. 201Tl was injected intravenously after 1 minute at the highest infusion rate, followed by immediate and delayed (4 hour) tomographic imaging. At the highest infusion rate, adenosine induced a significant (p less than 0.001) decrease in systolic (8.7 +/- 19.3 mm Hg) and diastolic (6.7 +/- 9.4 mm Hg) blood pressures as well as a significant (p = 0.0001) increase in heart rate (14.5 +/- 11.0 beats/min). Side effects occurred in 83% of the patients but resolved spontaneously within 1 or 2 minutes after discontinuing the adenosine infusion. Chest, throat, or jaw pain were the most frequent symptoms and occurred in 57% of the patients. Headache (35%) and flush (29%) were also common. Ischemic electrocardiographic changes occurred in 12% of the patients, and transient first-degree atrioventricular block occurred in 10%.

• OSTI ID: 6867291
• Journal Information: Circulation; (USA), Journal Name: Circulation; (USA) Vol. 82:1; ISSN 0009-7322; ISSN CIRCA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ADENOSINE
ANIMALS
ARTERIES
BETA DECAY RADIOISOTOPES
BIOLOGICAL FUNCTIONS
BIOLOGICAL HALF-LIFE
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CORONARIES
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DIAGRAMS
DIGESTIVE SYSTEM
DISEASES
ELECTROCARDIOGRAMS
ELECTRON CAPTURE RADIOISOTOPES
EXERCISE
FUNCTIONS
HEART
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MAMMALS
MAN
MUSCLES
MYOCARDIUM
NUCLEI
NUCLEOSIDES
NUCLEOTIDES
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
ORGANS
PAIN
PATIENTS
PHARYNX
PRIMATES
RADIOISOTOPE SCANNING
RADIOISOTOPES
RESPIRATORY SYSTEM
RIBOSIDES
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
SYMPTOMS
THALLIUM 201
THALLIUM ISOTOPES
VASODILATION
VERTEBRATES