Objective To explore the value of adenosine loaded 99Tcm-MIBI single photon emission computed tomography(SPECT)in evaluating the therapeutic effect of nicorandil on coronary microvascular angina(CMVA).Methods Sixty eight patients diagnosed with CMVA in the Second Affiliated Hospital of Xuzhou Medical University from January 2021 to March 2022 were selected and randomly divided into a control group and a nicorandil group,with 34 patients in each group,using a random number table method.The control group received isosorbide mononitrate in addition to conventional treatment,while the nicorandil group received nicorandil in addition to conventional treatment.Both groups were treated continuously for 3 months.All patients underwent adenosine loading 99Tcm-MIBI SPECT before and after treatment to measure the degree of myocardial perfusion defect(SDS),myocardial perfusion defect area(SRS),and degree of improvement of myocardial perfusion defect(SIS).Clinical symptoms,electrocardiogram changes,myocardial enzyme indicators[cardiac troponin Ⅰ(cTnⅠ),creatine kinase-MB(CK-MB),lactate dehydrogenase(LDH)],hemodynamic parameters[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),stroke volume(SV),cardiac output(CO),peripheral resistance(TPR),left ventricular work index(LVWI),and myocardial oxygen consumption(MVO2)]were evaluated.Results After treatment,the SDS and SRS of the nicorandil group were significantly lower than those of the control group(P＜0.01),and the SIS was significantly higher than that of the control group(all P＜0.01);The improvement of abnormal myocardial perfusion imaging was significantly better than that of the control group(x2=4.976,P＜0.05);the frequency,duration,and severity of angina attacks,Canadian Heart Association(CCS)grading,and incidence of ischemic changes on electrocardiogram were all lower than those of the control group(P＜0.01);The levels of serum cTnⅠ,CK-MB,and LDH were significantly lower than those in the control group(all P＜0.01);SBP,DBP,HR,LVWI,and MVO2 were significantly lower than those in the control group(all P＜0.01),while SV and CO were significantly higher than those in the control group(all P＜0.01).Conclusions Adenosine loaded 99Tcm-MIBI SPECT can effectively evaluate the therapeutic effect of nicorandil on CMVA,and nicorandil can improve myocardial perfusion defects and clinical manifestations in CMVA patients.
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