Comparison of adenosine, dobutamine, and exercise radionuclide ventriculography in the detection of coronary artery disease.

Abstract:

:The diagnostic values of adenosine, dobutamine, and exercise radionuclide ventriculography (RNVG) in the detection of coronary artery disease (CAD), and the characteristics of those patients who showed myocardial ischemia during the infusion of adenosine or dobutamine were assessed in 41 patients with suspected CAD. Sensitivity, specificity, and accuracy, respectively, for detecting patients with CAD were 35 (p < 0.01 vs. exercise RNVG), 100 and 46% (p < 0.01 vs. exercise RNVG) with adenosine RNVG, 74, 100 and 78% with dobutamine RNVG and 88, 71 and 85% with exercise RNVG. There was a significant difference in physiologic parameters during the provocation of ischemia by adenosine versus exercise RNVG, although these parameters were similar by dobutamine and exercise RNVG. Stepwise discriminant analysis revealed that the number of stenotic vessels was an important and independent predictor for the myocardial ischemia induced by each stress; the peak filling rate was the only predictor for adenosine-induced ischemia. Dobutamine induced myocardial ischemia in a way similar to that of exercise, and was more useful than adenosine for pharmacologic stress RNVG. The mechanism of the adenosine-induced ischemia seemed to differ from that of the ischemia induced by dobutamine or exercise, and to be closely associated with left ventricular diastolic function.

journal_name

Cardiology

journal_title

Cardiology

authors

Nagaoka H,Isobe N,Kubota S,Iizuka T,Imai S,Suzuki T,Nagai R

doi

10.1159/000177327

subject

Has Abstract

pub_date

1997-03-01 00:00:00

pages

180-8

issue

2

eissn

0008-6312

issn

1421-9751

journal_volume

88

pub_type

临床试验,杂志文章,随机对照试验
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