背景:本研究之目的在探究冠狀動脈疾病的病人，在腎上腺素性藥物的刺激下，其心室收縮期及舒張期功能有何變化？而病人在經皮冠狀動脈成形術成功改善冠狀動脈血流後，其心室功能之變化有無獲得改善？
方法:本研究對象包括12名冠狀動脈正常者(男性8人，女性4人，平均年齡61±7歲)，以及23名冠狀動脈疾病患者(男性16人，女性7人，平均年齡62±7歲)，在接受成功的經皮冠狀動脈成形術前後，接受多嘌它命壓力下的放射核種心室造影術。多嘌它命靜脈輸入的速率由5微克/每分鐘/每公斤起始，每10分鐘增加5微克/每分鐘/每公斤的速率，至本研究最大的靜脈輸入速串20微克/每分鐘/每公斤或病患出現心絞痛、高血壓(收縮壓大於210毫米汞柱)。在休息狀態及每一各別輸入速率均執行放射核種心室造影術。
而每一放射核種心室造影術均以左心室之時間 ─ 活度曲線分析出左心室收縮期功能參數 (射出分串，EF:最大射出速率，PER)以及舒張期功能參數(最大舒張速率，PER:收縮末期至最大舒張速率間期，TPFR)。
結果:正常人在多嘌它命靜脈輸入速率在0與20微克/每分鐘/每公斤時，左心室收縮期功能與舒張期功能參數呈現有統計學意義的變化(EF：59±6％to 69±7％，P<0.05；PER：3.2±0.5 to 5.2±0.7,p<0.05;PFR:3.1±0.5 to 4.7 ± 0.6,P <0.05;TPFR：140±30to 100±36，P<0.05)，而再冠狀動脈疾病組則呈現再心室舒張期功能異常的結果(EF：56±4%to 63±6％，P<0.05;PER：3.0±0.4to4.2±0.5，P<0.05:PFR：2.8±0.4 to 2.6 ± 0.6,NS;TPFR：170±33 to 250 ± 56,P<0.05)然而病人在成功的完成經皮帆狀動脈成形術後，則左心室對多嘌它命靜脈輸入的反應則恢復正常(EF:58±7%to67±8%,P<0.05; PER:3.1±0.5 to 4.5±0.4, P<0.05; PER:3.0±0.5 to 4.3±4.5, P<0.01; TRFR:151±50 to 123±33, P<0.05)。
結論:對於冠狀動脈疾病的患者以及成功完成經度冠狀動脈成形術後，評估病人在多嘌它命影響下之左心室收縮期及舒張期功能，是一種容易執行且具價值的診斷工作。冠狀動脈疾病的患者，其左心室舒張期功能在多嘌它命靜脈輸入所顯示之異常反應，在成功的完成經皮冠狀動脈成形術後則會獲得改善。

Background: The purpose of this investigation was to study the effects of adrenergic stimulation on left ventricular systolic and diastolic functions in the patients with coronary artery disease (CAD) and following successful percutaneous transluminal coronary angioplasty (PTCA).
Methods: Twelve normal subjects (M 8, F 4; aged 61 ± 7) and twenty-three patients (M 16, F 7; aged 62 ±7) with CAD and successful PTCA were included for dobu-tamine stress radionuclide ventriculography (RNV). Dobutamine infusion was started at 5 pg/kg/min with the increment of 5 pg/kg/min every 10 min until angina, high blood pressure (systolic BP > 210 mm Hg) or maximum dose was achieved (20 μg/kg/min). RNV was per-formed before dobutamine infusion and at each dose
level of dobutamine infusion. Parameters of left ventricular systolic function (ejection fraction, EF; peak ejection rate, PER) and diastolic function (peak filling rate, PFR; Time to peak filling rate, TPFR) were determined by computer analysis of left ventricular time-activity curve.
Results: During dobutamine infusion in normal subjects, the left ventricular systolic and diastolic functions changed significantly from baseline to the dobutamine infusion rate at 20 μg/kg/min (EF:59 ± 6% to 69± 7%, P < 0.05; PER: 3.2 ±0.5 to 5.2 ±0.7 end-diastolic volumes/sec, P < 0.05; PFR: 3.1 ±0.5 to 4.7 ±0.6 end-diastolic volumes/sec, P < 0.05; TPFR: 140 ±30 to 100 ±36 msec, P < 0.05). The CAD patients, before PTCA, demonstrated left ventricular diastolic dysfunction (EF:56 ±4% to 63 ± 6%, P < 0.05; PER: 3.0±0.4 to 4.2 ±0.5 end-diastolic volumes/sec, P < 0.05; PFR: 2.8 ±0.4to 2.6 ±0.6 end-diastolic volumes/sec, NS; TPFR: 170 ±33 to 250 ± 56 msec, P < 0.05). However, after successful PTCA, left ventricular functions response to dobutamine infusion were restored (Er: 58 ± 7% to 67 ± 8%, P < 0.05; PER: 3.1 ±0.5 to 4.5 ±0.4 end-dias-tolic volumes/sec, P < 0.05; PFR: 3.0 ±0.5 to 4.3 ±~ 0.5 end-diastolic volumes/sec, P < 0.01; TPFR: 151 ±50 to 123 ±33 msec, P <0.05).
Conclusions: RNV is an easily performed and valuable method in the evaluation of the adrenergic effects on left ventricular functions in CAD patients before and after successful coronary angioplasty. Left ventricular diastolic dysfunction induced by dobutamine infusion can be restored by successful PTCA in coronary patients.