Exercise supplementation to dipyridamole prevents hypotension, improves electrocardiogram sensitivity, and increases heart-to-liver activity ratio on Tc-99m sestamibi imaging

Vítola, João V.; Brambatti, José Carlos; Caligaris, Fábio; Lesse, Carlos R.; Nogueira, Paulo Roberto; Joaquim, A.I.; Loyo, Mario; Salis, F.V.; Paiva, Eleuses V.; Chalela, William Azem; Meneghetti, José Cláudio

doi:10.1067/mnc.2001.117204

Cited by 45 publications

(25 citation statements)

References 19 publications

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“…In the present study, the liver uptake of 99m Tc was higher in the pharmacological-stress group than in the exercise-stress group. This was consistent with the findings of the previous reports (7,(24)(25)(26). This was because exercise stress induced an enhanced uptake and longer-term retention in muscle as a result of the increased blood flow, especially to skeletal muscle.…”

Section: Pharmacological Versus Exercise Stresssupporting

confidence: 83%

Differences in Perfusion between Pharmacological Stress and Exercise Stress on Prone Myocardial SPECT

Maeda

Kubo

Futaki

et al. 2016

Annals of Nuclear Cardiology

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Backgrounds: Myocardial single-photon emission computerized tomography (SPECT) with the patient in the prone position has recently been applied to improve the percentage uptake (%uptake) in the inferior wall by reducing diaphragmatic attenuation. We hypothesized that the type of stress might cause a difference in the %uptake improvement in inferior regions in the prone position. The purpose of this study was to compare the %uptake improvement between exercise and pharmacological vasodilator stress in prone myocardial SPECT.

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Section: Pharmacological Versus Exercise Stresssupporting

confidence: 83%

Differences in Perfusion between Pharmacological Stress and Exercise Stress on Prone Myocardial SPECT

Maeda

Kubo

Futaki

et al. 2016

Annals of Nuclear Cardiology

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“…This significantly reduces the side effects and improves image quality. [23][24][25][26] Low-level exercise supplementation is not recommended for patients with LBBB, WPW, and ventricular pacing due to heart rate-related imaging artifacts.…”

Section: Dipyridamolementioning

confidence: 99%

ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers

Henzlova

Duvall

Einstein

et al. 2016

Journal of Nuclear Cardiology

503

386

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“…16 By adding exercise, the duration of adenosine or dipyridamole infusion could be shortened, which might result in fewer side effects during stress testing in patients undergoing MPI. 17,18 Moreover, by combining pharmacologic stress with low-dose exercise, splanchnic blood can be redistributed to the skeletal muscles, resulting in decreased liver or bowel activity and therefore better image quality. 19 The levels of adjunctive treadmill exercise usually depend on the patient's physical ability to exercise and achieve targeted heart rate.…”

mentioning

confidence: 99%

Safer stress tests for myocardial perfusion imaging

Cho

Jabin

Bom

2019

Journal of Nuclear Cardiology

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In this issue of the Journal of Nuclear Cardiology, Andrikopolou et al.1 conducted a systematic review of the safety of vasodilatory stress tests using adenosine and regadenoson for myocardial perfusion imaging (MPI). By searching SCOPUS with the predefined keywords, they selected 34 studies which include 22,957 patients. Among 34 studies, adenosine was used in 21 and regadenoson in 15, while both were used in two studies. The estimated incidence of overall and highgrade atrioventricular block (AVB) was 3.81% (95% CI 1.99%-6.19%) and 1.93% (95% CI 0.77%-3.59%), respectively. The incidence of AVB and high-grade AVB in adenosine group was 8.58% (95% CI 5.55%-12.21%) and 5.21% (95% CI 2.81%-8.30%), while that in regadenoson group was 0.30% (95% CI 0.04%-0.82%) and 0.05% (95% CI \ 0.001%-0.19%), respectively. They concluded that both overall and high-grade AVB are significantly less frequent with regadenoson compared to adenosine.Adenosine is a naturally occurring ligand of four distinct subtypes (A1, A2A, A2B, and A3) of cell membrane G protein-coupled receptors. It produces coronary artery vasodilatation by activating adenylyl cyclase that results in the opening of potassium channels. The opening of these channels in vascular smooth muscle cells hyperpolarizes the cells and inhibits voltage-gated calcium channels and intracellular calcium release, resulting in relaxation.2 The common actions of adenosine on different types of adenosine receptors are associated with several life-threatening side effects. Actions on the A1 receptor can induce AVB, while actions on A2B and A3 receptors can induce bronchoconstriction especially in patients with asthma or severe chronic obstructive pulmonary disease (COPD). The use of adenosine can be limited in a substantial number of patients as the prevalence of COPD can be found in 30% patients undergoing adenosine MPI.

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Exercise supplementation to dipyridamole prevents hypotension, improves electrocardiogram sensitivity, and increases heart-to-liver activity ratio on Tc-99m sestamibi imaging

Cited by 45 publications

References 19 publications

Differences in Perfusion between Pharmacological Stress and Exercise Stress on Prone Myocardial SPECT

Differences in Perfusion between Pharmacological Stress and Exercise Stress on Prone Myocardial SPECT

ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers

Safer stress tests for myocardial perfusion imaging

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