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Myocardial perfusion imaging findings and the role of adenosine in the warm-up angina phenomenon

^a Quebec Heart Institute/Laval Hospital, Laval University, Sainte-Foy, Quebec, Canada

View larger version (17K): [in a new window]   Figure 1 The ischemic threshold and the adjusted maximum (max) ST segment depression in exercises 1 and 2 of the scintigraphic study (substudy A). The ischemic threshold is the heart rate-systolic blood pressure product x 10–3 at the appearance of 1 mm ST segment depression. Adjusted max ST depression is the maximum ST segment depression corresponding to the highest heart rate-systolic blood pressure product common to both exercises. Exercise 1 is the baseline exercise electrocardiogram Tl-201 test, which was used in the analysis, and exercise 2 is the warmed-up Tl-201 test of the third exercise session. Tl-201 = thallium-201.

View larger version (16K): [in a new window]   Figure 2 The myocardial Tl-201 percent extent and percent maximum deficit perfusion defects at exercises 1 and 2 in substudy A. Exercise 1 is the baseline exercise Tl-201 test, which was used in the analysis, and exercise 2 is the warmed-up Tl-201 test of the third exercise session. Tl-201 = thallium-201.

View larger version (38K): [in a new window]   Figure 3 Ischemic thresholds of ex 1 and 2 at the 2 ex sessions. Subjects received intravenous saline at one session and intravenous aminophylline at the other session. See Figure 1 and text for definition of the ischemic threshold. *Aminophylline at ex 1 versus saline at ex 1, p = 0.016. ex = exercise.

View larger version (33K): [in a new window]   Figure 4 Adjusted maximum (max) ST segment depression of ex 1 and 2 at the saline and aminophylline exercise electrocardiogram sessions. See Figure 2 and text for definition of adjusted maximum ST depression. ex = exercise. *Decrease in adjusted max ST depression from ex 1 to ex 2 with aminophylline compared with decrease with saline, p = 0.012.