PURPOSE:To further investigate the clinical significance of transient ischemic dilation (TID) on myocardial perfusion imaging (MPI) by analyzing the effect of anisodamine hydrobromide (a drug that can effectively ameliorate microcirculation) on the patients with isolated TID and the findings of previous literatures. METHODS:Total 107 patients with isolated TID (TID value≥1.11) were randomly divided into group A (n = 36; intravenous administration of anisodamine hydrobromide), group N (n = 36; intravenous administration of isosorbide dinitrate), and group C (n = 35; intravenous administration of normal saline). MPI and treadmill exercise test (TET) were performed again after 14-day course of intervention. Pre- and post-intervention frequencies of symptom were recorded. RESULTS:In group A, after intervention of anisodamine hydrobromide, the summed stress score (SSS) and TID value on MPI significantly decreased than those before intervention (P < 0.001), the durations of exercise (DEs) and metabolic equivalents (METs) in TET notably ascended (P < 0.001), as well as the symptom remarkably improved. In group N and group C, there were no significant differences in SSS, TID value, DEs, METs, and frequencies of symptom between pre- and post-intervention (P > 0.05). No significant improvement of symptoms in group N before and after treatment. CONCLUSIONS:TID with perfusion defect may usually predict a possibility of severe and extensive coronary artery disease (CAD). An isolated TID should be considered as a likelihood of coronary microvascular dysfunction (CMD). TET and coronary CT angiography (cCTA) are extremely helpful for the antidiastole on CAD and CMD. The administration of anisodamine hydrobromide might be an optional treatment for the patients with isolated TID.

中文翻译：

---

冠状动脉微血管功能障碍：左心室短暂性缺血性扩张对心肌灌注显像临床意义的重要解释

目的：通过分析山莨菪碱氢溴酸盐（一种可有效改善微循环的药物）对孤立性TID患者的影响以及以往文献的研究结果，进一步探讨短暂性脑缺血扩张（TID）对心肌灌注显像（MPI）的临床意义。 . 方法：将107例孤立性TID患者（TID值≥1.11）随机分为A组（n=36；山莨菪碱静脉给药）、N组（n=36；硝酸异山梨酯静脉给药）和C组（ n = 35；静脉注射生理盐水）。MPI 和跑步机运动测试 (TET) 在 14 天的干预过程后再次进行。记录干预前和干预后症状的频率。结果：A组，山莨菪碱氢溴酸盐干预后，MPI 的总压力评分（SSS）和 TID 值比干预前显着降低（P < 0.001），TET 的运动持续时间（DEs）和代谢当量（METs）显着增加（P < 0.001），以及症状明显好转。N组和C组干预前后SSS、TID值、DEs、METs、症状频率均无显着差异（P > 0.05）。N组治疗前后症状无明显改善。结论：具有灌注缺陷的 TID 通常可以预测严重和广泛的冠状动脉疾病 (CAD) 的可能性。孤立的 TID 应被视为冠状动脉微血管功能障碍 (CMD) 的可能性。TET 和冠状动脉 CT 血管造影 (cCTA) 对 CAD 和 CMD 的抗舒张非常有帮助。