,Quantitative Evaluation of the Antiischemic Effect of Isosorbide Dinitrate

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Objectives To evaluate the anti-ischemic effect of ISDN on the patients with coronary heart disease. The change in the size of the defect area as percentage of the entire myocardium as determined by the unfolded surface mapping between the baseline and after ISDN infusion reflects the anti-ischemic effect of ISDN. Methods and Results 99m Tc-MIBI myocardial perfusion SPECT images were acquired,and reconstruction of the bull’s eye map and unfolded surface mapping were performed according to the dates of tomography images. In the group Ⅰ (99mTc-MIBI was injected at 30 minutes after the start of ISDN iv drip):at the 65% threshold value, the percentage of the defect area size in the whole ventricle was 33.01 ±5.35% at baseline, (28.9 ±5.23)% after ISDN was infused (P < 0.05); at the 55% threshold value, the percentage of the defect area size in the whole ventricle was (22.06±5.58)% at baseline, (19.60±4.07)% after ISDN was infused (P < 0.05); the sum of defect blood ST segments is 60 at baseline, 51 after ISDN was infused. In the group Ⅱ (99mTc-MIBI was injected at 60 minutes after the start of ISDN iv drip): at the 65% threshold value, the percentage of the defect area size in the whole ventricle was (29.20±5.08)% at baseline,(20.81±4.16)% after ISDN was infused (P < 0.001 );at the 55% threshold value, the percentage of the defect area size in the whole ventricle was (21.2 ±5.49)% at baseline, (17.52 ±5.59)% after ISDN was infused (P < 0.001); the sum of defect blood ST segments is 58 at baseline, 47 after ISDN was infused.In the group Ⅲ (99mTc-MIBI was injected at 150 minutes after the start of ISDN iv drip): at the 65% threshold value, the percentage of the defect area size in the whole ventricle was (32.87 ±6.46)% at baseline,(20.81±4.16)% after ISDN was infused (P < 0.001);at the 55% threshold value, the percentage of the defect area size in the whole ventricle was (18.42 ±5.17)% at baseline, (14.18±3.61)% after ISDN was infused (P< 0.001); the sum of defect blood ST segments was 64 at baseline, 41 after ISDN was infused.Conclusions The unfolded surface mapping of 99mTc-MIBI myocardial perfusion image can be used as a method of quantitatively evaluating the anti-ischemic effect of drugs and ISDN iv drip can improve the blood flow in myocardium (myocardium perfusion).
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