The value of adenosine loading 99Tc m-MIBI SPECT in evaluating the therapeutic effect of nicorandil on coronary microvascular angina pectoris
10.3760/cma.j.cn431274-20230928-00333
- VernacularTitle:腺苷负荷 99Tc m-MIBI SPECT评价尼可地尔对冠脉微血管心绞痛疗效的价值
- Author:
Nan TANG
1
;
Bo YU
;
Dan WANG
;
Xiaodan FAN
;
Nannan YIN
;
Chunmei QI
Author Information
1. 徐州医科大学第二附属医院心内科，徐州 221000
- Keywords:
Single photon emission computed tomography computed tomography;
Technetium Tc 99m sestamibi;
Nicorandil;
Coronary microvascular angina
- From:
Journal of Chinese Physician
2024;26(7):1035-1041
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of adenosine loaded 99Tc m-MIBI single photon emission computed tomography (SPECT) in evaluating the therapeutic effect of nicorandil on coronary microvascular angina (CMVA). Methods:Sixty eight patients diagnosed with CMVA in the Second Affiliated Hospital of Xuzhou Medical University from January 2021 to March 2022 were selected and randomly divided into a control group and a nicorandil group, with 34 patients in each group, using a random number table method. The control group received isosorbide mononitrate in addition to conventional treatment, while the nicorandil group received nicorandil in addition to conventional treatment. Both groups were treated continuously for 3 months. All patients underwent adenosine loading 99Tc m-MIBI SPECT before and after treatment to measure the degree of myocardial perfusion defect (SDS), myocardial perfusion defect area (SRS), and degree of improvement of myocardial perfusion defect (SIS). Clinical symptoms, electrocardiogram changes, myocardial enzyme indicators [cardiac troponin I (cTnI), creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH)], hemodynamic parameters [systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), stroke volume (SV), cardiac output (CO), peripheral resistance (TPR), left ventricular work index (LVWI), and myocardial oxygen consumption (MVO 2)] were evaluated. Results:After treatment, the SDS and SRS of the nicorandil group were significantly lower than those of the control group ( P<0.01), and the SIS was significantly higher than that of the control group (all P<0.01); The improvement of abnormal myocardial perfusion imaging was significantly better than that of the control group (χ 2=4.976, P<0.05); the frequency, duration, and severity of angina attacks, Canadian Heart Association (CCS) grading, and incidence of ischemic changes on electrocardiogram were all lower than those of the control group ( P<0.01); The levels of serum cTnI, CK-MB, and LDH were significantly lower than those in the control group (all P<0.01); SBP, DBP, HR, LVWI, and MVO 2 were significantly lower than those in the control group (all P<0.01), while SV and CO were significantly higher than those in the control group (all P<0.01). Conclusions:Adenosine loaded 99Tc m-MIBI SPECT can effectively evaluate the therapeutic effect of nicorandil on CMVA, and nicorandil can improve myocardial perfusion defects and clinical manifestations in CMVA patients.
