Predictors of abnormal heart rate response to dipyridamole in patients undergoing myocardial perfusion SPECT

Lima, Ronaldo de Souza Leão; Machado, Luı́s dos Ramos; Azevedo, Alexandre B.; Lorenzo, Andrea De

doi:10.1007/s12149-010-0420-8

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…Smoking habit and the use of β-blocker might deteriorate the pharmaceutical action of adenosine. Higher rest HR and lower EF in the reduced HR response group were consistent with the findings of previous studies [ 4 – 6 ]. In these studies with comparatively larger populations on myocardial perfusion SPECT, reduced HR response was related to SRS and SSS, and not to SDS; however, the present preliminary study did not demonstrate differences of SRS, SSS, and SDS between the groups.…”

Section: Discussionsupporting

confidence: 92%

Patients with reduced heart rate response to adenosine infusion have low myocardial flow reserve in 13N-ammonia PET studies

Tomiyama

Kumita

Ishihara

et al. 2015

Int J Cardiovasc Imaging

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To assess the effect of adenosine infusion by evaluating the relationship between heart rate (HR) response to adenosine and myocardial flow reserve (MFR) of remote regions supplied by normal coronary arteries in 13N-ammonia PET. Thirty-one consecutive subjects (20 known coronary artery disease patients, 4 chronic heart failure patients, and 7 normal volunteers) except cases having 3-vessel disease underwent rest and adenosine stress 13N-ammonia myocardial perfusion PET. Semi-quantitative, quantitative, and gated analyses were performed. Subjects were divided into two groups with regard to HR response to adenosine. Twenty-two subjects had normal HR response (peak/rest HR > 1.20), while reduced HR response (≤1.20) was observed in nine subjects. There were no differences in rest myocardial blood flow (MBF) of remote regions between the groups. Subjects with reduced HR response had significantly lower stress MBF and MFR of remote regions than those with normal HR response (stress MBF: 1.559 ± 0.517 vs. 2.279 ± 0.530, p = 0.004, MFR: 1.59 ± 0.36 vs. 2.35 ± 0.53, p = 0.001). There were no significant differences between the groups by means of semi-quantitative scoring. Rest and stress ejection fraction (EF) in the reduced HR response group was lower than that in the normal HR response group. In a multiple stepwise regression analysis, HR ratio, dyslipidemia, and Brinkman index were identified as predictors of the change in MFR of remote regions. Subjects with reduced HR response to adenosine had lower stress MBF and MFR of remote regions and lower EF. Moreover, HR response was one of the predictors of the change in MFR of remote regions.

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Section: Discussionsupporting

confidence: 92%

Patients with reduced heart rate response to adenosine infusion have low myocardial flow reserve in 13N-ammonia PET studies

Tomiyama

Kumita

Ishihara

et al. 2015

Int J Cardiovasc Imaging

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Relationship between gated myocardial perfusion SPECT findings and hemodynamic, electrocardiographic, and heart rate changes after Dipyridamole infusion

Gholoobi

Ayati

Baghyari

et al. 2017

Int J Cardiovasc Imaging

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After dipyridamole infusion, electrocardiographic (ECG), blood pressure and heart rate (HR) changes were seen. We tried to investigate whether there is a relationship between hemodynamic, ECG and HR changes after dipyridamole infusion and gated myocardial perfusion SPECT findings. We studied 206 consecutive patients which underwent a 2-day protocol Dipyridamole Stress/Rest Tc99m-Sestamibi gated myocardial perfusion SPECT. Systolic blood pressure (SBP), diastolic blood pressure (DBP), HR and ECG were recorded. HR was mildly increased while SBP and DBP were mildly decreased after Dipyridamole infusion. There was only statistically significant difference between ECG changes as well as transient ischemic dilation (TID) ratio between normal scans and scans with ischemia (P = 0.02 and P = 0.01 respectively). There was correlation between these variables and summed stress score (SSS) and summed difference score (SDS). Patients with ischemia in their scans, 44.3% had ST depression after Dipyridamole infusion. Also ST depression most frequently was seen in patients with left anterior descending artery disease. From patients with abnormal scan + ST depression after Dipyridamole infusion (33 patient), 27 patient (81.81%) had ischemia. There was an association between TID ratio as well as ECG changes after Dipyridamole infusion and SSS, SDS and coronary artery territory abnormality. Difference between calculated left ventricular ejection fraction using stress and rest images had significant correlation with SSS and SDS. ST depression after Dipyridamole infusion and TID ratio had association with ischemia, SSS and SDS. So in equivocal Gated SPECT findings, they could be very useful for interpretation.

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Reduced heart rate response to dipyridamole in patients undergoing myocardial perfusion SPECT

et al. 2012

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Predictors of abnormal heart rate response to dipyridamole in patients undergoing myocardial perfusion SPECT

Abstract: LV dysfunction is an independent predictor of abnormal HR response to DIP, and the association between low LVEF and low HR ratio may explain the link between abnormal HR ratio and increased mortality.

Cited by 3 publications

References 16 publications

Patients with reduced heart rate response to adenosine infusion have low myocardial flow reserve in 13N-ammonia PET studies

Patients with reduced heart rate response to adenosine infusion have low myocardial flow reserve in 13N-ammonia PET studies

Relationship between gated myocardial perfusion SPECT findings and hemodynamic, electrocardiographic, and heart rate changes after Dipyridamole infusion

Reduced heart rate response to dipyridamole in patients undergoing myocardial perfusion SPECT

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