STATE-OF-THE-ART PAPER
The Effects of Medications on Myocardial Perfusion
Gilbert J. Zoghbi, MD, FACC,
Todd A. Dorfman, MD* and
Ami E. Iskandrian, MD, MACC
Division of Cardiovascular Diseases, Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama.
Manuscript received March 19, 2008;
revised manuscript received April 14, 2008,
accepted April 21, 2008.
* Reprint requests and correspondence: Dr. Todd A. Dorfman, Division of Cardiovascular Diseases, The University of Alabama–Birmingham, LHRB 306, 1530 3rd Avenue South, Birmingham, Alabama 35294-0007. (Email: tdorfman{at}cardmail.dom.uab.edu).
Antianginal and lipid-lowering medications may modify the results of stress myocardial perfusion imaging. Several studies have shown the beneficial potential of these agents in suppressing myocardial ischemia in patients with known coronary artery disease. The effects of nitrates, calcium-channel blockers, beta-blockers, and statins on myocardial perfusion imaging are likely attributable to changes in myocardial blood flow and myocardial oxygen supply–demand ratio. This comprehensive review examines relevant experimental and clinical published data. Technical issues in image interpretation specific to myocardial perfusion imaging and implications of use of cardiac medications to results of myocardial perfusion imaging are discussed.
Key Words: myocardial perfusion imaging • beta-blockers • calcium-channel blockers • lipid-lowering medications • SPECT
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Abbreviations and Acronyms
| | BB = beta-blocker | | CAD = coronary artery disease | | CCB = calcium-channel blocker | | CFR = coronary flow reserve ratio | | LDL = low-density lipoprotein | | MBF = myocardial blood flow | | MPI = myocardial perfusion imaging | | PCI = percutaneous coronary intervention | | PET = positron emission tomography | | SPECT = single-photon emission computed tomography |
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