Prognostic Value of Myocardial Perfusion SPECT After Intravenous Bolus Administration of Nicorandil in Patients with Acute Ischemic Heart Failure

Fukushima, Yoshimitsu; Kumita, Shin‐ichiro; Tokita, Yukichi; Sato, Naoki

doi:10.2967/jnumed.115.162420

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…This disease has an urgent onset, complicated etiology, and the possibility of death, which puts forward high requirements for treatment [ 14 , 15 ]. When the symptoms of myocardial ischemia occur, the coronary artery blood flow in the patient's body is continuously reduced, resulting in the continuous weakening of the metabolic capacity in the patient's body, and then, hypoxia occurs [ 16 ]. In the past, aspirin was widely used in clinical treatment, which could alleviate the myocardial ischemia symptoms of patients to a certain extent, but the effect was not obvious [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Effect of Nicorandil Combined with Aspirin in the Treatment of Myocardial Ischemia

Chen

Xiong

et al. 2022

BioMed Research International

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Objective. To investigate the clinical effect of nicorandil combined with aspirin in the treatment of myocardial ischemia. Methods. A total of 104 patients with myocardial ischemia were admitted to our hospital from June 2019 to August 2020. These patients were selected as the research objects and randomly divided into two groups: the control group and the observation group. The control group was given asilin, and the observation group was given nicorandil tablets based on the control group. Both groups were given continuous treatment for 3 months. The curative effect, cardiac function indexes, dynamic electrocardiogram, and the occurrence of adverse reactions were observed in the two groups. Results. The total effective rate of the observation group was 96.15% (50/52), which was higher than that of the control group (61.54%, 32/52), and the difference was statistically significant ( P < 0.05 ). After treatment, left ventricular ejection fraction (LVEF) and peak early/late diastolic flow velocity (E/A) were increased ( P < 0.05 ), while peak early diastolic flow velocity to peak mitral annular root movement velocity (E/Ea) was decreased ( P < 0.05 ). After treatment, LVEF and E/A in the observation group were higher than those in the control group, while E/Ea was lower than that in the control group ( P < 0.05 ). The frequency, duration of ST segment, and a total load of myocardial ischemia in the ST segment within 24 h after treatment were decreased compared with those before treatment ( P < 0.05 ). The frequency and duration of ST segment decreased, and the total load of myocardial ischemia in the observation group was lower than those in the control group within 24 h after treatment ( P < 0.05 ). After treatment, the total occurrence of adverse reactions in the observation group was lower than that in the control group ( P < 0.05 ). Conclusion. Nicorandil combined with aspirin in the treatment of patients with myocardial ischemia has a significant effect, which can effectively improve the electrocardiogram and cardiac function indicators of patients and reduce the incidence of adverse reactions and is worthy of clinical application.

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Section: Discussionmentioning

confidence: 99%

Clinical Effect of Nicorandil Combined with Aspirin in the Treatment of Myocardial Ischemia

Chen

Xiong

et al. 2022

BioMed Research International

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“…[31] Nicorandil prevents lipid deposition in the arterial walls and cells and has anti-atherosclerotic effects. [32] Nicorandil is the preferred drug for treating PMVA. [20,33] Hcy is an intermediate product of methionine metabolism that reflects the metabolic status of the vascular endothelium and is an independent risk factor for cardiovascular diseases.…”

Section: Introductionmentioning

confidence: 99%

“…(4) An elevated blood lipid level is an important factor in atherosclerosis [30] . Nicorandil prevents lipid deposition in the arterial walls and cells and has anti-atherosclerotic effects [32] . Nicorandil is the preferred drug for treating PMVA [20,33] …”

Section: Introductionmentioning

confidence: 99%

Cardiovascular magnetic resonance image analysis and mechanism study for the changes after treatments for primary microvascular angina pectoris

Huang

Wang²,

Wang³

et al. 2021

Medicine

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Most cases of primary microvascular angina pectoris (PMVA) are diagnosed clinically, but the etiology and pathological mechanisms are unknown. The effect of routine clinical medications is minimal, and PMVA can progress to serious cardiovascular events. To improve the diagnosis and effective treatment of this disease, this study was designed to diagnose PMVA via cardiovascular magnetic resonance (CMR) and the coronary angiography thrombolysis in myocardial infarction (TIMI) blood flow grade, as well as to analyze vascular endothelial function to elucidate the pathogenesis of PMVA and compare the effects of routine clinical medications.The present randomized controlled trial including a parallel control group will be conducted on 63 PMVA patients in our cardiovascular department. The patients will be selected and randomly divided into the control, diltiazem, and nicorandil groups. The control group will be administered routine drug treatments (aspirin, atorvastatin, betaloc ZOK, perindopril, and isosorbidemononitrate sustained-release tablets). The diltiazem group will be additionally treated with 90 mg qd diltiazem sustained-release capsules. The nicorandil group was additionally given 5 mg tid nicorandil tablets. Coronary angiography will be performed before treatment, the severity and frequency of chest pain will be evaluated before and after 9 months of treatment, and homocysteine and von Willebrand factor levels will be measured. Electrocardiography, echocardiography, dynamic electrocardiography, a treadmill exercise test, and CMR will be performed. Sex, age, body mass index, complications, smoking, and family history will also be recorded. The SPSS19.0 statistical software package will be used to analyze the data. The measurements will be expressed as the mean ± standard deviation. Measurement data will be compared between the groups using Student's t-test. A relative number description will be used for the counting data, and the chi-squaretest will be used to compare the groups. A multivariate logistic regression analysis will be performed A P-value < .05 will be considered significant.The direct indices (CMR and coronary angiographic TIMI blood flow grade) may improve after adding diltiazem or nicorandil during routine drug treatments (such as aspirin, statins, and nitrates) in PMVA patients, and indirect indices (homocysteine and von Willebrand factor levels) may be reduced.Trial registration:Chinese Clinical Trial Registry (http://www.chictr.org.cn/showprojen.aspx?proj=41894), No. CHiCTR1900025319, Registered on August 23, 2019; pre initiation.

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Feasibility of myocardial flow reserve prediction without the use of dynamic data from myocardial perfusion positron emission tomography

Hashimoto

Fukushima

Kumita

et al. 2018

Int J Cardiovasc Imaging

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Quantification of myocardial flow reserve (MFR) provides diagnostic value for detection of cardiovascular artery disease. However, the common calculation method for MFR requires dynamic acquisition and specific software. The study aimed to predict coronary artery disease by simpler calculation of myocardial count without the use of dynamic data from N-ammonia myocardial perfusion positron emission tomography (MP-PET). This study included 40 consecutive patients suspected of ischemic heart disease and 7 healthy controls (34 men and 13 women, 66 ± 12 years). All participants underwent adenosine stress and restN-ammonia MP-PET. From the dynamic images, the MFR in the entire left ventricular myocardium (ELV) and the three-vessel area was calculated by dividing stress myocardial blood flow (MBF) by rest MBF. From the static images, the myocardium-to-background ratio (MBR) was calculated by dividing each area's counts/pixel by background counts in the upper thoracic aorta/pixel in both stress and rest images. The MBR-increasing rate (MBR-IR) was calculated by dividing stress MBR by rest MBR. The relationship between MFR and MBR-IR in each area was examined. The cutoff diagnostic value of MBR-IR corresponding to that of MFR for detection of cardiovascular artery disease was calculated. Each MBR-IR was closely correlated with each MFR (r = 0.830 in ELV, r = 0.864 in LAD, r = 0.829 in LCX, r = 0.757 in RCA). The cutoff values of MBR-IR were 1.45 in ELV, 1.46 in LAD, 1.41 in LCX, and 1.45 in RCA, respectively. This study demonstrated that quantification of MBR-IR may provide diagnostic value for detection of coronary artery disease as well as MFR.

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Prognostic Value of Myocardial Perfusion SPECT After Intravenous Bolus Administration of Nicorandil in Patients with Acute Ischemic Heart Failure

Cited by 4 publications

References 24 publications

Clinical Effect of Nicorandil Combined with Aspirin in the Treatment of Myocardial Ischemia

Clinical Effect of Nicorandil Combined with Aspirin in the Treatment of Myocardial Ischemia

Cardiovascular magnetic resonance image analysis and mechanism study for the changes after treatments for primary microvascular angina pectoris

Feasibility of myocardial flow reserve prediction without the use of dynamic data from myocardial perfusion positron emission tomography

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