Adenosine Triphosphate Stress 99mТС-MIBI Single-Photon Emission Computed Tomography in the Diagnosis Miocardial Iscemia in Patients With Microvascular Angina

Karpova, I.E. Karpova; Samoĭlenko, L E; Соболева, Г. Н.; Sergiyenko, V.B. Sergiyenko; Karpov, Yu. A.; Чернышева, И. Е.; Иоселиани, Д. Г.

doi:10.18565/cardio.2014.7.4-8

Cited by 4 publications

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“…After 3 min, 99m Tc-MIBI 740 MBq was injected from the other pathway. Prior to the intravenous ATP injection, a 12-lead electrocardiogram (ECG), blood pressure test, heart rate and symptoms were recorded at various time points, as follows: At 3 min before injection, right after injection, 3 min after injection, and we monitored them during the entire procedure (10). …”

Section: Methodsmentioning

confidence: 99%

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Adenosine triphosphate stress 99mTc-methoxyisobutylisonitrile gated myocardial perfusion imaging efficacy in diagnosing stent restenosis following coronary stent implantation

Peng-fei

Song

et al. 2016

Experimental and Therapeutic Medicine

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Coronary stent restenosis rate following implantation is considerably high. The adenosine stress gated myocardial perfusion imaging (G-MPI) method has been widely used in the diagnosis, risk stratification and prognosis evaluation of coronary heart disease; however, the high cost of adenosine limits its clinical application. The aim of the present study was to investigate the efficacy of adenosine triphosphate (ATP) stress 99mTc-methoxyisobutylisonitrile (99mTc-MIBI) G-MPI for diagnosis in-stent restenosis following coronary stent implantation. Data from 66 patients with typical angina pectoris symptoms who had undergone percutaneous coronary stent implantation >3 months prior to participation in the study were analyzed. All the patients underwent ATP stress 99mTc-MIBI G-MPI and coronary artery angiography as the criterion diagnostic standard within 1 month. The sensitivity, specificity, and accuracy of ATP stress 99mTc-MIBI G-MPI in the assessment of in-stent restenosis were calculated. In addition, Fisher's exact probability methods were used to compare differences between experimental groups. Among 66 patients with a total of 99 implanted coronary arterial branches, 39 patients (59%) with 45 coronary arteries (45%) presented in-stent restenosis. The diagnostic sensitivity, specificity, accuracy, positive predictive and negative predictive value of ATP stress 99mTc-MIBI G-MPI for assessing stent restenosis in all patients were 85, 89, 86, 92 and 80%, respectively. Similarly, these values in patients with myocardial infarction were 79, 88, 83, 88 and 78%, respectively, while in patients without myocardial infarction the values were 90, 91, 90, 95 and 83%, respectively. Therefore, the diagnostic efficacy of ATP stress 99mTc-MIBI G-MPI in patients without myocardial infarction was higher compared with those with myocardial infarction; however, no significant difference was observed between the two groups. Furthermore, the sensitivity, specificity and accuracy for diagnosing LAD stent restenosis were higher compared with LCX and RCA stent restenosis, but with no significant differences observed (P>0.05). The present results indicated that ATP stress 99mTc-MIBI G-MPI had a high clinical application value for diagnosing in-stent restenosis following coronary stent implantation as a non-invasive examination tool, with the advantages of safety and low cost.

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Section: Methodsmentioning

confidence: 99%

“…However, adenosine is costly and, thus, there is reason to identify similar pharmaceuticals to replace it. Adenosine triphosphate (ATP) is a similar compound to adenosine regarding its pharmacological mechanism, but also inexpensive and thus more suitable for use in clinical practice (10). …”

Section: Introductionmentioning

confidence: 99%

Adenosine triphosphate stress 99mTc-methoxyisobutylisonitrile gated myocardial perfusion imaging efficacy in diagnosing stent restenosis following coronary stent implantation

Peng-fei

Song

et al. 2016

Experimental and Therapeutic Medicine

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“…Согласно рекомендациям Европейского общества кардиологов по стабильной ИБС [1] наиболее высокой чувствительностью и специфичностью в выявлении ишемии миокарда ЛЖ обладают методы, оценивающие перфузию миокарда ЛЖ в сочетании с фармакологическими тестами (магнитно-резонансная томография, однофотонная эмиссионная КТ, КТ). Учитывая 90% чувствительность КТ-ангиографии в оценке анатомических изменений в КА [2], а также высокую эффективность фармакологической пробы АТФ в выявлении ишемии миокарда ЛЖ по данным однофотонной эмиссионной КТ в наших исследованиях [5], в сочетании с КТ сердца зарубежных исследователей [6,7], мы сочли целесообразным проведение объемной КТ сердца с фармакологической пробой АТФ у нашей пациентки с целью верификации ишемии миокарда ЛЖ в бассейне ПНА. В конечном итоге именно этот метод позволил с высокой точностью, сравнимой с инвазивным измерением ФРК, определить гемодинамическую значимость стеноза ПНА и показание к чрескожному коронарному вмешательству -стентированию ПНА.…”

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The study of myocardial perfusion by cardiac volumetric computed tomography, combined with adenosine triphosphate test, in a patient with painless myocardial ischemia and atherosclerosis of the coronary arteries

Соболева

Николаевна²,

Гаман

et al. 2020

Terapevticheskii arkhiv

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The presented clinical observation demonstrates the diagnostic capabilities of cardiac volumetric computed tomography (CT) with a pharmacological test by a vasodilator adenosine triphosphate (ATP) in the simultaneous assessment of coronary anatomy and changes in left ventricular myocardial perfusion (LV) in a patient with painless myocardial ischemia and coronary atherosclerosis. A 68-year-old patient with coronary heart disease (CHD) and atherosclerotic changes in the coronary arteries underwent cardiac volumetric CT in combination with a ATP pharmacological test. The study was performed on a Aquilion ONE 640 Vision Edition computer tomograph (Toshiba, Japan). Assessment of LV myocardial perfusion was carried out in comparison with other clinical, laboratory and instrumental examination methods. The results of clinical and instrumental examination of a patient with a low pre-test probability of coronary heart disease are presented. From the standpoint of modern recommendations on stable coronary heart disease, false-negative results of single-photon emission computed tomography of the heart and stress-echocardiography are discussed. Clinical observation demonstrates the feasibility of diagnosing LV myocardial ischemia by cardiac volumetric CT combined with ATP pharmacological test, confirmed by an invasive determination of the fractional flow reserve. The given clinical example represents the advantage of cardiac volumetric CT, combined with the ATP pharmacological test, as a method for visualizing LV myocardial perfusion in detecting myocardial ischemia.

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Echocardiographic Stress Test with Adenosine Triphosphate: Optimization of the Algorithm

et al. 2019

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Purpose. To: 1) optimize algorithm of stress echocardiography (s-Echo) with intravenous adenosine triphosphate (ATP) infusion taking into account pharmacokinetics and pharmacodynamics of ATP in human body, 2) test new algorithm in patients with coronary and other heart diseases. Materials and methods. In order to determine spectrum of factors influencing the results of stress test with ATP we inspected main scientific data bases and found 48 publications on ATP application for diagnostic purposes. Analysis of these publications allowed us to optimize algorithm of ATP s-Echo. Optimized algorithm was tested on 26 subjects, who underwent ATP 4D strain-stress-echocardiography of the left ventricle. Results and discussion. Optimized algorithm has three stages: registration of Echo data sets before, at the time of ATP infusion, and after 5 min of ATP infusion termination. Registration of Echo parameters at the second stage must begin not earlier than 3 min after the onset of ATP infusion and only in the presence of signs of coronary vasodilation. We think that the main indirect criterion of submaximal coronary vasodilation is 5 mm Hg or more decrease in systolic blood pressure (SBP), but not below SBP level of 90 mm Hg. Initial dose of ATP is 140 µg/kg/min. If after 2 min of infusion SBP do not diminish we increase the infusion rate at first to 175 and then to 210 µg/kg/min. While testing new algorithm in all cases we have achieved criteria of effective vasodilation. Mean SBP decrease was 16.4±13.7 mm Hg, heart rate increase – 12.7±8.1 bpm. In all patients we obtained interpretable 4D LV Echo data sets for visual analysis of local contractility and automatic strain analysis. Conclusion. Optimization of ATP sEcho algorithm was performed. Safety and efficacy of optimized algorythm for registration of echo data was demonstrated. New ATP infusion algorithm can also be recommended for testing with other cardiac imaging modalities in evaluation of myocardial perfusion and contractility (SPECT, CT, MRI, PET).

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Adenosine Triphosphate Stress 99mТС-MIBI Single-Photon Emission Computed Tomography in the Diagnosis Miocardial Iscemia in Patients With Microvascular Angina

Cited by 4 publications

References 0 publications

Adenosine triphosphate stress 99mTc-methoxyisobutylisonitrile gated myocardial perfusion imaging efficacy in diagnosing stent restenosis following coronary stent implantation

Adenosine triphosphate stress 99mTc-methoxyisobutylisonitrile gated myocardial perfusion imaging efficacy in diagnosing stent restenosis following coronary stent implantation

The study of myocardial perfusion by cardiac volumetric computed tomography, combined with adenosine triphosphate test, in a patient with painless myocardial ischemia and atherosclerosis of the coronary arteries

Echocardiographic Stress Test with Adenosine Triphosphate: Optimization of the Algorithm

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