Combined arm exercise and dipyridamole stress thallium imaging for the detection of coronary artery disease
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The safety and usefulness of combined isotonic-isometric arm exercise along with dipyridamolethallium 201 imaging for the detection of coronary artery disease (CAD) was tested in 50 patients. Dipyridamole (0.5 mg/kg) was injected i.v. for 4 minutes, followed by a 4-minute exercise of both arms. Fifty matched patients receiving dipyridamole only were imaged for comparison. Peak heart rate (mean 118 vs 77 b/minutes) and peak systolic and diastolic blood pressure were significantly higher in the exercised group. Evidence of myocardial ischemia, ST depression (82% vs 60%), Th-201 redistribution (85% vs 68%), and the target-to-background counts ratio were also more profound in this group, though side effects were fewer. It is concluded that arm exercise combined with dipyridamole-thallium imaging is safe and provides more reliable results in assessing CAD than dipyridamole alone followed by Th-201 imaging. It is therefore recommended for patients who are unable to perform lower limb exercise.
KeywordsCoronary Artery Disease Diastolic Blood Pressure Myocardial Ischemia Thallium Dipyridamole
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