title: 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.
abstract: 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.
authors.affiliation: Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea.
authors.forename: Kyung Ah
authors.initials: KA
authors.lastname: Chun
authors.forename: Jaetae
authors.initials: J
authors.lastname: Lee
authors.forename: Sang-Woo
authors.initials: SW
authors.lastname: Lee
authors.forename: Byeong-Cheol
authors.initials: BC
authors.lastname: Ahn
authors.forename: Jeoung-Hee
authors.initials: JH
authors.lastname: Ha
authors.forename: Ihn Ho
authors.initials: IH
authors.lastname: Cho
authors.forename: Shung Chull
authors.initials: SC
authors.lastname: Chae
authors.forename: Kyu Bo
authors.initials: KB
authors.lastname: Lee
mesh_terms: 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*
chemical_list: D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; D000255:Adenosine Triphosphate; D000241:Adenosine