Original articleComparison of myocardial blood flow and coronary flow reserve during dobutamine and adenosine stress: Implications for pharmacologic stress testing in coronary artery disease
Section snippets
Methods
We recruited 36 male patients (mean age [± SD], 61 ± 8 years [range, 46-77 years]) from St Mary’s and Hammersmith Hospitals in London, United Kingdom. All described a history of chronic stable angina and demonstrated significant single-vessel coronary artery disease (CAD) during coronary angiography (stenoses >50% of luminal diameter). Exclusion criteria included a recent history (<3 months) of myocardial infarction or unstable angina, valvular heart disease, atrial fibrillation, or bundle
Results
We divided 36 patients into 2 groups based on stenosis severity: moderate (>50% but <75%) (n = 16) and severe (>75%) (n = 20). Half of the patients in each group (n = 8 with moderate stenosis and n = 10 with severe stenosis) underwent adenosine stress testing, whereas the other half underwent dobutamine stress testing. Coronary artery stenosis severity was comparable between the adenosine and dobutamine subgroups (63% ± 2% vs 69% ± 6% for those with moderate stenosis [P = not significant] and
Discussion
The principle underlying myocardial perfusion imaging relies on the identification of differential flow reserve between myocardium subtended by a stenotic coronary artery and that supplied by arteries with less severe or no disease at angiography. Our study has demonstrated progressive blunting of regional MBF and CFR in the presence of increasing coronary artery stenosis to a similar degree with both agents, although in remote myocardial segments adenosine achieved significantly greater
Acknowledgment
The authors have indicated they have no financial conflicts of interest.
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