TY - JOUR
T1 - Pharmacologic stress myocardial perfusion imaging
AU - Patel, Rakesh N.
AU - Arteaga, Roque B.
AU - Mandawat, Mahendra K.
AU - Thornton, John W.
AU - Robinson, Vincent J.B.
PY - 2007/10
Y1 - 2007/10
N2 - Pharmacologic stress agents (dipyridamole, adenosine and dobutamine) allow virtually all patients to be safely assessed for ischemic heart disease. These agents have mild but significant side effects, mandating a thorough knowledge of indications, contraindications, side effects and management before their use. Adjunctive exercise improves image quality in vasodilator pharmacologic myocardial perfusion imaging. Diabetics, especially women, have a much higher cardiac event rate than nondiabetics for an equal amount of ischemia. They also have a higher incidence of asymptomatic ischemia. There is growing support for screening with myocardial perfusion imaging (MPI) for asymptomatic ischemia in diabetics. The ability of MPI to identify hypocontractile but viable myocardium, thus predicting improvement in myocardial function after revascularization, is one of the most powerful uses of the modality. Vasodilator MPI should be used as the initial test in patients with left bundle branch block or paced ventricular rhythm, even if they are able to exercise.
AB - Pharmacologic stress agents (dipyridamole, adenosine and dobutamine) allow virtually all patients to be safely assessed for ischemic heart disease. These agents have mild but significant side effects, mandating a thorough knowledge of indications, contraindications, side effects and management before their use. Adjunctive exercise improves image quality in vasodilator pharmacologic myocardial perfusion imaging. Diabetics, especially women, have a much higher cardiac event rate than nondiabetics for an equal amount of ischemia. They also have a higher incidence of asymptomatic ischemia. There is growing support for screening with myocardial perfusion imaging (MPI) for asymptomatic ischemia in diabetics. The ability of MPI to identify hypocontractile but viable myocardium, thus predicting improvement in myocardial function after revascularization, is one of the most powerful uses of the modality. Vasodilator MPI should be used as the initial test in patients with left bundle branch block or paced ventricular rhythm, even if they are able to exercise.
KW - Choice of stress tests
KW - Coronary heart disease
KW - Vasodilator stress testing
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U2 - 10.1097/SMJ.0b013e318153f9c6
DO - 10.1097/SMJ.0b013e318153f9c6
M3 - Review article
C2 - 17943047
AN - SCOPUS:35148866179
SN - 0038-4348
VL - 100
SP - 1006
EP - 1014
JO - Southern medical journal
JF - Southern medical journal
IS - 10
ER -