The impact of adenosine pharmacologic stress combined with low-level exercise in patients undergoing myocardial perfusion imaging (BIWAKO adenosine-Ex trial)
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Hajime Monzen Masatake Hara Makoto Hirata Takatoshi Suzuki Makoto Ogasawara Hirokazu Higuchi Tomohiro Matsuoka Hisato Kobayashi Rumio
- چاپ و سال / کشور: 2011
Description
Background The combination of adenosine infusion with low-level exercise has become a common approach for inducing stress during stress myocardial perfusion imaging (MPI). We investigated stress MPI performed by combined low-level exercise and adenosine infusion. This combined protocol can decrease adverse reactions and reduce the effect of scattered rays from the liver. Methods and results Subjects were clinically referred for a 53-min rest-stress Tc-99m Sestamibi MPI procedure using BIWAKO PROTOCOL. Ninety-eight patients (44.5%) underwent adenosine infusion with ergometer exercise testing and 122 patients (55.5%) underwent adenosine infusion without exercise testing. We evaluated the liver/heart (L/H) uptake ratio, background activity in the upper mediastinum, and adverse reactions. Results The L/H ratio and background activity were lower in the adenosine-exercise group than in the adenosine- non-exercise group (1.8 ± 0.54 vs. 2.1 ± 0.62, P\0.0056; 43.1 ± 12.2 vs. 61.5 ± 15.4, P\0.0001). The adenosine-exercise group had fewer adverse reactions than the adenosine–non-exercise group (11.2 vs. 19.7%). All of the adverse reactions were minor, with the exception of severe back pain in one case. The incidence of adverse reactions in our study was lower than that in previous studies for unknown reason. Conclusion Adenosine infusion in combination with lowlevel exercise seems to result in higher-quality images and fewer adverse reactions than adenosine infusion without exercise. The combined protocol decreases adverse reactions and improves the quality of myocardial perfusion images by decreasing background activity.
Ann Nucl Med (2011) 25:381–386 DOI 10.1007/s12149-011-0475-1 Received: 21 September 2010 / Accepted: 6 January 2011 / Published online: 9 March 2011
