Direct comparison of adenosine and adenosine 5'-triphosphate as pharmacologic stress agents in conjunction with Tl-201 SPECT: Hemodynamic response, myocardial tracer uptake, and size of perfusion defects in the same subjects.
BACKGROUND
Adenosine 5'-triphosphate (ATP), a potent and inexpensive coronary vasodilator, was introduced as a pharmacologic stress agent for thallium 201 single photon emission computed tomography (SPECT). However, there has been no direct comparison of ATP and adenosine as myocardial stressors in the same subjects.


RESULTS
Thirty-six patients underwent consecutive Tl-201 SPECT imaging with adenosine and ATP in a randomly assigned order. There were no changes in clinical status and no invasive procedures were performed between the two tests. The hemodynamic response and side effects were monitored, and myocardial tracer uptake was assessed by use of a visual grading system and quantitative analysis via a CEqual map. The hemodynamic changes and adverse effects did not differ significantly between the two groups. There were no changes in the detection of any perfusion defect on a per-subject basis, except in one. The exact agreement rate for the visual grading of the myocardial tracer uptake was 84.8%. However, the average extent of the perfusion defect and the severity score were higher with adenosine.


CONCLUSIONS
The hemodynamic changes and the degree of myocardial uptake were similar between the adenosine and ATP infusion. However, quantitative analysis by use of a CEqual map revealed smaller perfusion defects and lower severity scores in subjects undergoing Tl-201 SPECT with ATP.
Chun
Kyung Ah
KA
Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea.
Lee
Jaetae
J
Lee
Sang-Woo
SW
Ahn
Byeong-Cheol
BC
Ha
Jeoung-Hee
JH
Cho
Ihn Ho
IH
Chae
Shung Chull
SC
Lee
Kyu Bo
KB
D000241:Adenosine / Q000494:pharmacology*; D000255:Adenosine Triphosphate / Q000494:pharmacology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; D000255:Adenosine Triphosphate; D000241:Adenosine