Technetium-99m Methoxyisobutyl Isonitrile Stress MPI in Suspected Coronary Artery Disease Patients: A Prospective Study to Evaluate Clinical Significance of Adenosine-induced ECG Changes.

IF 0.4 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Indian Journal of Nuclear Medicine Pub Date : 2024-01-01 Epub Date: 2024-03-27 DOI:10.4103/ijnm.ijnm_71_23
N C Valaiyapathy, Ramya Priya Rallapeta, D S Hemalatha, V S Krishna Mohan, D Rajasekhar, Tekchand Kalawat
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Abstract

Purpose: The purpose of this study is to evaluate the adenosine pharmacological stress-induced electrocardiogram (ECG) changes and their association with stress-induced ischemic defects on myocardial perfusion scintigraphy (MPS) in the evaluation of coronary artery disease (CAD) and to evaluate event-free survival among patients with positive and negative ECG/MPS image findings.

Methods: A total of 100 patients were examined using stress MPS from March 2020 to August 2021. Stress-induced ECG changes during adenosine infusion were evaluated. The summed stress score (SSS) was evaluated to identify ischemic defects in myocardium. Association of stress ECG changes and scintigraphic results was evaluated.

Results: Out of 100 patients, stress ECG changes during adenosine infusion were seen among 34 patients, whereas 66 patients had normal ECG findings. Positive stress MPS findings with SSS >3 were seen in 22 patients, whereas 78 patients had SSS ≤3. There was no agreement between stress ECG changes and MPS findings with Cohen's kappa coefficient (κ) = -0.023, whereas there was mild agreement between stress ECG changes and SSS >7 with κ = 0.105. Median follow-up of 11 months showed more events among patients with positive ECG changes than negative ECG changes.

Conclusion: Adenosine, pharmacological stress is safe to use, but few patients might experience some minor and transient symptoms. Adenosine may induce ECG changes in patients with or without positive MPS findings. Patients with concordant positive findings need aggressive cardiac care, whereas patients with small or no defects on MPS need close monitoring.

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疑似冠状动脉疾病患者的锝-99m 甲氧基异丁基腈压力 MPI:评估腺苷诱导心电图变化临床意义的前瞻性研究。
目的:本研究旨在评估腺苷药理应激诱导的心电图(ECG)变化及其与应激诱导的心肌灌注闪烁成像(MPS)缺血缺氧的关联,以评价冠状动脉疾病(CAD),并评估ECG/MPS图像阳性和阴性患者的无事件生存率:方法:2020年3月至2021年8月,共对100名患者进行了负荷MPS检查。方法:2020 年 3 月至 2021 年 8 月期间,共对 100 名患者进行了应激 MPS 检查,评估了腺苷输注期间应激诱导的心电图变化。评估应激总分(SSS)以确定心肌缺血缺损。评估应激心电图变化与闪烁成像结果的关联:结果:在 100 名患者中,34 名患者在输注腺苷期间出现了应激心电图变化,而 66 名患者的心电图结果正常。22 例患者的应激 MPS 阳性,SSS>3,而 78 例患者的 SSS ≤3。应激心电图变化与 MPS 结果不一致,科恩卡帕系数 (κ) = -0.023,而应激心电图变化与 SSS >7 之间有轻微的一致性,κ = 0.105。中位随访时间为11个月,结果显示心电图呈阳性变化的患者比心电图呈阴性变化的患者发生的事件更多:结论:使用腺苷这种药物应激是安全的,但少数患者可能会出现一些轻微和短暂的症状。无论是否有 MPS 阳性结果,腺苷都可能诱发患者的心电图变化。有一致的阳性结果的患者需要积极的心脏护理,而 MPS 有小缺陷或无缺陷的患者则需要密切监测。
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来源期刊
Indian Journal of Nuclear Medicine
Indian Journal of Nuclear Medicine RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
0.70
自引率
0.00%
发文量
46
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