Comparison of Adenosine Stress Myocardial Perfusion Scintigraphy and Oral Dipyridamole Stress Myocardial Perfusion Scintigraphy for Hemodynamic Changes and Adverse Effects
Year 2016,
Volume: 17 Issue: 2, 90 - 97, 01.08.2016
Objective: Similar effects can be achieved during stress myocardial perfusion scintigraphy (MPS) using pharmacological agents to create cardiac stress for patients who are unable to exercise. In our study, we aimed to show the hemodynamic changes and adverse effects caused by adenosine and to compare the results with dipyridamole stress MPS. Materials and Methods: Sixty-five patients with suspected coronary artery disease were included in our study. Fifty patients in whom stress MPS with intravenous adenosine was performed (group A) and 15 patients who underwent oral dipyridamole stress MPS (group B) were retrospectively evaluated. During the test, blood pressure measurements and electrocardiographic follow-up were performed in all patients and side effects were noted. Results: At least one side effect occurred in 68% of the group A and in 46% of the group B patients. There was no statistically significant difference between the two groups in terms of side effects that occurred during the pharmacological stress. During the maximum stress, there was an increase of 15.80±11.60 beats/min in heart beats in group A and 5.53±4.54 beats/min in group B. There was a statistically significant difference between the groups in terms of heart rate increase per minute. When we compared reduction in systolic blood pressure and diastolic blood pressure, there was no statistically significant difference between the two groups. Conclusion: Although side effects are more often seen with adenosine, rapid decline in complaints was observed when adenosine infusion was terminated and there was no need for patient follow-up due to short half life of adenosine. We believe that these favourable advantages will increase the use of adenosine in clinical practice.
4. Leppo JA. Dipyridamole-thallium imaging: the lazy man’s stress
test. J Nucl Med 1989; 30: 281-7.
5. Guyton AC. Text book of Medical Physiology. Koroner dolaşım ve
iskemik kalp hastalığı. 7 th ed. WB Saunders: Nobel Tıp Kitabevi,
1986: 423-30.
6. Gupta NC, Esterbrooks DJ, Hilleman DE, Mohiuddin SM.
Comparison of adenosine and exercise thallium-201 singlephoton
emission computed tomography (SPECT) myocardial
perfusion imaging. The GE SPECT Multicenter Adenosine Study
Group. J Am Coll Cardiol 1992; 19: 248-57.
7. Picano E, Lattuzi F, Masini M, Distante A, L’Abbate A. High dose
dipyridamole echocardiography test in effort angina pectoris. J
Am Coll Cardiol 1986; 8: 848-54.
8. Henzlova MJ, Cerqueira MD, Hansen CL, Taillefer R, Yao S. ASNC,
Imaging guidelines for nuclearcardiology procedures, Stress
protocols and tracers. J Nucl Cardiol 2009. https://static-content.
springer.com/esm/art%3A10.1007%2Fs12350-009-9062-4/
MediaObjects/12350_2009_9062_MOESM1_ESM.pdf
9. Gordon L, Hendrix GH. The use of pharmacological agents in
myocardial perfusion imaging. In: Freeman LM, editor. Nuclear
medicine annual 1994. Philadelphia: Lippincott Williams and
Wilkins, 1994; 121-40.
10. Kubo S, Tadamura E, Toyoda H, Mamede M, Yamamuro M,
Magata Y, et al. Effect of caffeine intake on myocardial hyperemic
flow induced by adenosine triphosphate and dipyridamole. J
Nucl Med 2004; 45: 730-8.
11. Zaret BL, Wackers FJ. Nuclear cardiology (1). N Eng J Med 1993;
329: 775-83.
12. Taillefer R, Amyot R, Turpin S, Lambert R, Pilon C, Jarry
M. Comparison between dipyridamole and adenosine as
pharmacologic coronary vasodilators in detection of coronary
artery disease withthallium 201imaging. J Nucl Cardiol 1996; 3:
204-11.
13. Biaggioni I, Killian TJ, Mosqueda-Garcia R, Robertson RM,
Robertson D. Adenosine increasessympathetic nerve traffic in
humans. Circulation 1991; 83: 1668-75.
14. Knabb RM, Gidday JM, Ely SW, Rubio R, Berne RM. Effects of
dipyridamole on myocardial adenosine and active hyperemia.
Am J Physiol 1984; 247: 804-10.
15. Iskandrian AS, Verani MS, Heo J. Pharmacologic stress testing:
mechanism of action, hemodynamic responses and results in
detection of coronary artery disease. J Nuc Cardiol 1994; 1: 94-
111.
16. Cerqueire MD, Verani MS, Schwaiger M, Heo J, Iskandrian AS.
Safety profile of adenosine stress perfusion imaging: results
from the adenoscan multicenter trial registry. J Am Coll Cardiol
1994; 23: 384-9.
17. Granato JE, Watson DD, Beladinelli L, Cannon JM, Beller GA. Effects
of dipyridamole and aminophylline and hemodynamics, regional
myocardial blood flow and thallium-201 washout in the setting of
a critical coronary stenosis. J Am Coll Cardiol 1990; 16: 1760-70.
18. Johnston DL, Daley JR, Hodge DO, Hopfenspirger MR, Gibbons
RJ. Hemodynamic responses and adverse effects associated
with adenosine and dipyridamole pharmacologic stress testing:
a comparison in 2,000 patients. Mayo Clin Proc 1995; 70: 331-6.
19. Verani MS, Mahmarian JJ, Hisson JB, Boyce TM, Staudacher RA.
Diagnosis of coronary artery disease by controlled coronary
vasodilation with adenosine and thallium-201 scintigraphy in
patiens unable to exercise. Circulation 1990; 82: 80-7.
20. Creager MA, Cooke JP, Mendelsohn ME, Gallagher SJ, Coleman SM,
Loscalzo J, et al. Impaired vasodilation of forearm resistance vessels
in hypercholesterolemic humans. J Clin Invest 1990; 86: 228-34.
İntravenöz Adenozin ve Oral
Dipiridamol ile Miyokard Perfüzyon
Sintigrafisi Uygulanan Hastalarda
Hemodinamik Değişiklikler ile Yan
Etkilerin Karşılaştırılması
Year 2016,
Volume: 17 Issue: 2, 90 - 97, 01.08.2016
4. Leppo JA. Dipyridamole-thallium imaging: the lazy man’s stress
test. J Nucl Med 1989; 30: 281-7.
5. Guyton AC. Text book of Medical Physiology. Koroner dolaşım ve
iskemik kalp hastalığı. 7 th ed. WB Saunders: Nobel Tıp Kitabevi,
1986: 423-30.
6. Gupta NC, Esterbrooks DJ, Hilleman DE, Mohiuddin SM.
Comparison of adenosine and exercise thallium-201 singlephoton
emission computed tomography (SPECT) myocardial
perfusion imaging. The GE SPECT Multicenter Adenosine Study
Group. J Am Coll Cardiol 1992; 19: 248-57.
7. Picano E, Lattuzi F, Masini M, Distante A, L’Abbate A. High dose
dipyridamole echocardiography test in effort angina pectoris. J
Am Coll Cardiol 1986; 8: 848-54.
8. Henzlova MJ, Cerqueira MD, Hansen CL, Taillefer R, Yao S. ASNC,
Imaging guidelines for nuclearcardiology procedures, Stress
protocols and tracers. J Nucl Cardiol 2009. https://static-content.
springer.com/esm/art%3A10.1007%2Fs12350-009-9062-4/
MediaObjects/12350_2009_9062_MOESM1_ESM.pdf
9. Gordon L, Hendrix GH. The use of pharmacological agents in
myocardial perfusion imaging. In: Freeman LM, editor. Nuclear
medicine annual 1994. Philadelphia: Lippincott Williams and
Wilkins, 1994; 121-40.
10. Kubo S, Tadamura E, Toyoda H, Mamede M, Yamamuro M,
Magata Y, et al. Effect of caffeine intake on myocardial hyperemic
flow induced by adenosine triphosphate and dipyridamole. J
Nucl Med 2004; 45: 730-8.
11. Zaret BL, Wackers FJ. Nuclear cardiology (1). N Eng J Med 1993;
329: 775-83.
12. Taillefer R, Amyot R, Turpin S, Lambert R, Pilon C, Jarry
M. Comparison between dipyridamole and adenosine as
pharmacologic coronary vasodilators in detection of coronary
artery disease withthallium 201imaging. J Nucl Cardiol 1996; 3:
204-11.
13. Biaggioni I, Killian TJ, Mosqueda-Garcia R, Robertson RM,
Robertson D. Adenosine increasessympathetic nerve traffic in
humans. Circulation 1991; 83: 1668-75.
14. Knabb RM, Gidday JM, Ely SW, Rubio R, Berne RM. Effects of
dipyridamole on myocardial adenosine and active hyperemia.
Am J Physiol 1984; 247: 804-10.
15. Iskandrian AS, Verani MS, Heo J. Pharmacologic stress testing:
mechanism of action, hemodynamic responses and results in
detection of coronary artery disease. J Nuc Cardiol 1994; 1: 94-
111.
16. Cerqueire MD, Verani MS, Schwaiger M, Heo J, Iskandrian AS.
Safety profile of adenosine stress perfusion imaging: results
from the adenoscan multicenter trial registry. J Am Coll Cardiol
1994; 23: 384-9.
17. Granato JE, Watson DD, Beladinelli L, Cannon JM, Beller GA. Effects
of dipyridamole and aminophylline and hemodynamics, regional
myocardial blood flow and thallium-201 washout in the setting of
a critical coronary stenosis. J Am Coll Cardiol 1990; 16: 1760-70.
18. Johnston DL, Daley JR, Hodge DO, Hopfenspirger MR, Gibbons
RJ. Hemodynamic responses and adverse effects associated
with adenosine and dipyridamole pharmacologic stress testing:
a comparison in 2,000 patients. Mayo Clin Proc 1995; 70: 331-6.
19. Verani MS, Mahmarian JJ, Hisson JB, Boyce TM, Staudacher RA.
Diagnosis of coronary artery disease by controlled coronary
vasodilation with adenosine and thallium-201 scintigraphy in
patiens unable to exercise. Circulation 1990; 82: 80-7.
20. Creager MA, Cooke JP, Mendelsohn ME, Gallagher SJ, Coleman SM,
Loscalzo J, et al. Impaired vasodilation of forearm resistance vessels
in hypercholesterolemic humans. J Clin Invest 1990; 86: 228-34.
Yanarateş A, Hatipoğlu F, Akgün A, Kumanlıoğlu K (August 1, 2016) Comparison of Adenosine Stress Myocardial Perfusion Scintigraphy and Oral Dipyridamole Stress Myocardial Perfusion Scintigraphy for Hemodynamic Changes and Adverse Effects. Meandros Medical And Dental Journal 17 2 90–97.