Combined arm exercise and dipyridamole stress thallium imaging for the detection of coronary artery disease
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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- 5.Gleim G, Coplan N, Scandura M, Holly T, Nicholas J (1988) Rate pressure product at equivalent oxygen consumption on four different exercise modalities. J Cardiopulmonary Rehabil 8:270–275.Google Scholar
- 6.Kouidi E, Galitsanos S, Mougios V, Kotzamanidis C, Deligiannis A (1993) Cardiovascular responses to exercise by canoe and kayak. Med Sci Res 21:271–273.Google Scholar
- 13.Young D, Guiney T, McKusick K, Okada R, Strauss W, Boucher C (1987) Unmasking potential myocardial ischemia with dipyridamole thallium imaging in patients with normal submaximal exercise thallium tests. Am J Noninvasive Cardiol 1:11–14.Google Scholar
- 14.Chamberlein B (1980) Comparison of dipyridamole and treadmill exercise for enhancing thallium-201 perfusion defects in patients with coronary artery disease. Eur J Cardiol 1:275–282.Google Scholar