Clinical Value Of Atropine-four Minute Adenosine ⁹⁹Tc^m-MIBI Myocardial Perfusion Imaging For Coronary Artery Disease

Objective: To assess the clinical value of atropine-four minute adenosine infusion 99Tcm-MIBI myocardial perfusion imaging for coronary artery disease(CAD).Methods : Three groups: atropine-four-minute adenosine infusion(group 1),four-minute adenosine infusion(group 2) and six-minute adenosine infusion(group 3). 1mg atropine was injected intravenously ten minutes before adenosine infusion in the group 1. In three groups, adenosine was infused at a rate of 0.14mg·kg-1·min-1 intravenously for four,four and six minutes. Three minutes after adenosine infusion, 740mBq of 99Tcm-MIBI were injected intravenously. SPECT myocardial imaging acquisition was obtained 1.5 hours after adenosine infusion,rest myocardial perfusion imaging would be performed following day.Results:⑴In three groups, the sensitivity,specificity,diagnostic accuracies of CAD were 83%,86%,84% and 81%,70%,78% and 85%,86%,85%,respectively( P >0.05). The sensitivity of the adenosine test for detection of single vessel,two vessel,three vessel disease of CAD was 83%,85%,80% in group 1,80%,89%,71% in group 2 and 88%,86%,80% in group 3,respectively(P>0.05).⑵Some changes of hemodynamics appeared 2-3 minutes after adenosine infusion in three groups: blood pressure(BP) has a drop and heart rate(HR),rate-pressure product(RPP) increased. Among the three groups, the changes was not significantly different(P>0.05).⑶Atrioventricular block and the changes of ST segment in three groups occurred 1%,6%,7% and 33%,28%,30%,respectively(P=NS).⑷In three groups, General side effects occurred 72%,78%,81%. The incidence of side effects in the three groups was not significantly different besides chest depressed(38% and 63%,P <0.05).Conclusions : In comparison with four-minute infusion and six-minute infusion, atropine-four-minute adenosine infusion has high clinical value and similar diagnostic efficacy for myocardial ischemia of CAD, has similar effect on inducing the changes of hemodynamics and ECG,is safer and lower incidence of chest depressed than the standard six minute infusion.