Safety and clinical value of ATP-induced stress myocardial perfusion imaging in the diagnosis of coronary heart disease

Abstract

Objective To assess the safety and clinical value of ATP-induced stress MPI (ATP-MPI) in the diagnosis of coronary heart disease (CHD). Methods A total of 83 patients (61 males, 22 females, age: 43-68(55.4±6.7) years) with suspected CHD were included. Rest MPI was performed 90 min post injection of 296 MBq 99Tcm-MIBI. ATP was infused intravenously 3 h later at a rate of 0.16 mg·kg-1·min-1 for 5 min. Then, a dose of 925 MBq 99Tcm-MIBI was injected intravenously 3 min post ATP infusion. ATP-MPI was performed 90 min later. All patients underwent CAG within 1 week after MPI to evaluate the diagnostic efficiency of ATP-MPI. The adverse reaction was observed. Results Ninety-nine diseased vessels were identified by CAG in 64 patients: 38 patients had one-vessel disease, 17 patients had two-vessel disease and 9 patients had three-vessel disease. ATP-MPI detected 91 diseased vessels (38 LAD, 29 LCX and 24 RCA) in 60 patients. In the diagnosis of CHD, ATP-MPI had a sensitivity of 85.9% (55/64), a specificity of 14/19, an accuracy of 83.1% (69/83), a positive predictive value of 91.7% (55/60) and a negative predictive value of 60.9% (14/23). The adverse reaction incidence of ATP stress test was 84.3%(70/83). The symptoms included mild hypotension, palpitations, shortness of breath, dizziness and facial flush, which all resolved spontaneously without any treatment. Conclusion ATP-MPI is a noninvasive, convenient and safe imaging modality for the diagnosis of CHD, and can be routinely used. Key words: Coronary disease; Tomography, emission-computed, single-photon; Adenosine triphosphate