ABSTRACT
Dipyridamole TI-201 imaging is an ideal alternative to exercise TI-201 scintigraphy in patients who are unwilling or unable to perform maximum exercise stress. The use of intravenous dipyridamole, alone or in combination with exercise, has not been approved for clinical practice by the Food and Drug Administration. Once approval is granted, the test will become a widely used and important component of the cardiac work-up. The indications, methodology, side effects, and utility of dipyridamole cardiac imaging in the clinical setting are discussed and a variety of examples presented.
Subject(s)
Coronary Disease/diagnostic imaging , Dipyridamole , Heart/diagnostic imaging , Thallium Radioisotopes , Tomography, Emission-Computed, Single-Photon/methods , Dipyridamole/administration & dosage , Dipyridamole/adverse effects , Exercise Test , Humans , Image Processing, Computer-Assisted , Infusions, Intravenous , United States , United States Food and Drug AdministrationABSTRACT
Tl-201 exercise imaging in patients with left bundle branch block (LBBB) has proven to be indeterminate for significant left anterior descending (LAD) coronary artery stenosis because of the presence of immediate septal perfusion defects with redistribution on delayed images in almost all cases. Tl-201 redistribution occurs regardless of the presence or absence of LAD stenosis. Nineteen patients having LBBB were evaluated with dipyridamole Tl-201 SPECT. Fourteen of these subjects had normal dipyridamole Tl-201 SPECT imaging. Three patients had normal coronary angiograms. None of the remaining 11 patients with normal dipyridamole Tl-201 SPECT images was found to have clinical coronary artery disease in a 5-11 month follow-up period. Five patients had abnormal septal perfusion. Four underwent coronary angiography. One had a significant LAD stenosis. The single patient with septal redistribution who refused to undergo coronary angiography died shortly thereafter of clinical coronary artery disease. This preliminary work suggests that dipyridamole Tl-201 SPECT may be more useful for excluding LAD stenosis in patients with LBBB than Tl-201 exercise imaging.
Subject(s)
Bundle-Branch Block/diagnostic imaging , Dipyridamole , Thallium Radioisotopes , Tomography, Emission-Computed , Adult , Aged , Aged, 80 and over , Coronary Disease/diagnostic imaging , Diagnosis, Differential , Exercise Test , Female , Humans , Male , Middle AgedABSTRACT
Mean survival times were increased an average of 23, 53 and 61%, when 10, 15, and 20 mg/kg, respectively, of the organoplatinum congener, malonato(1,2-diaminocyclohexane) platinum(II)(NSC-224964), was given as the only treatment modality to BDF1 mice bearing 1-day-old L1210 leukemia. When a single dose of 10 mg/kg was combined with either 300 or 100 R on day 1 only, the anticipated response (ILS = 30 and 38%, respectively) based on the additive effects of the single modalities was surpassed by 26 and 21%, respectively (i.e. extent of therapeutic synergism). When divided doses of radiation (200 R/day x 3 days) were combined with 15 or 20 mg/kg of NSC-224964, survival times were enhanced an average of 15% (extent of synergism) greater than would be expected if these modalities were acting through an additive process(es).
