Trial reportJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
Effect of antianginal medication on resting myocardial perfusion and pharmacologically induced hyperemia.
Trial report in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- The effect of beta blocker withdrawal on adenosine myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2014Trial
- The effect of beta-blockers on the diagnostic accuracy of vasodilator pharmacologic SPECT myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear CardiologyTrial
- Effect of Beta-Blocker Consumption on the Severity and Extension of Perfusion Defects in Dipyridamole Myocardial Perfusion Single-Photon Emission Computed Tomography.World journal of nuclear medicine · 2024Article
- High Resting Coronary Flow Velocity by Echocardiography Is Associated With Worse Survival in Patients With Chronic Coronary Syndromes.Journal of the American Heart Association · 2024Observational
- Dynamic myocardial CT perfusion imaging-state of the art.European radiology · 2023Review
- Drug Use Evaluation of Beta-Blockers in Medical Wards of Nedjo General Hospital, Western Ethiopia.Cardiovascular therapeutics · 2020Article
- Diagnostic accuracy of combined coronary angiography and adenosine stress myocardial perfusion imaging using 320-detector computed tomography: pilot study.European radiology · 2013Article
- Article
- Withholding or continuing beta-blocker treatment before dipyridamole myocardial perfusion imaging for the diagnosis of coronary artery disease? A randomized clinical trial.Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences · 2013Article
- Best patient preparation before and during radionuclide myocardial perfusion imaging studies.Journal of nuclear cardiology : official publication of the American Society of Nuclear CardiologyArticle
- Antianginal medications and diagnostic accuracy of myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear CardiologyArticle
- Symptom-limited exercise during vasodilator stress: best of both worlds?Journal of nuclear cardiology : official publication of the American Society of Nuclear CardiologyArticle
- Patient preparation for nuclear imaging: when should anti-ischemic medications be withheld?Journal of nuclear cardiology : official publication of the American Society of Nuclear CardiologyArticle
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7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients scheduled for myocardial perfusion imaging are often taking several antianginal drugs. There is presently no consensus concerning a regimen of discontinuation before either rest or pharmacologic stress myocardial perfusion imaging. Whether antianginal treatment affects diagnostic sensitivity and specificity is not well documented. Methods and results The effect of the three most commonly used antianginal drugs (nitroglycerin, 400 microg [NTG]; metoprolol, 50 mg [MET]; and amlodipine, 5 mg [AML]) on myocardial perfusion was tested in 49 patients (age, 63 +/- 8 years; 43 men) allocated prospectively to one of the treatments (NTG, n = 25; MET, n = 14; and AML, n = 10). All patients had documented coronary artery disease and were scheduled for elective percutaneous coronary intervention. Patients were studied once on treatment and once off treatment with an interval of 1 to 3 weeks. For NTG, the measurements were performed on the same day with an interval of 1 hour. The MET and AML groups were also studied during dipyridamole-induced hyperemia (0.56 mg. kg(-1). min(-1) for 4 minutes). So that a quantitative value of myocardial perfusion in milliliters per gram per minute could be obtained, myocardial perfusion was quantified with nitrogen 13 ammonia positron emission tomography as an average of the midventricular perfusion in each of the 3 vascular territories. NTG treatment increased the overall resting perfusion (0.75 +/- 0.18 vs 0.86 +/- 0.22, P <.05), whereas resting perfusion was reduced after MET treatment (0.92 +/- 0.14 vs 0.82 +/- 0.17, P <.05). AML treatment did not alter resting perfusion (0.87 +/- 0.22 vs 0.87 +/- 0.23, P = NS). Dipyridamole-induced hyperemia was reduced after treatment with MET (2.02 +/- 0.66 vs l.57 +/- 0.52, P <.001), whereas the hyperemic response was unchanged after treatment with AML (1.54 +/- 0.49 vs 1.86 +/- 0.91, P = NS).
conclusionsAntianginal medication can alter both resting and hyperemic myocardial perfusion and might affect the ability to detect flow-limiting stenosis. NTG increases perfusion, MET reduces perfusion, and AML does not affect perfusion. Larger-scale trials are warranted to establish a consensus for optimal antianginal medication for patients undergoing perfusion imaging.
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