Detection and assessment of the severity of coronary artery disease by dipyridamole echocardiography test
Dipyridamole is a potent coronary arteriolar vasodilator that has been employed in combination with thallium-201 imaging for the detection of coronary artery disease. Since a coronary stenosis may significantly reduce the regional coronary reserve without inducing ischemia, the presence of coronary artery disease can be documented by the different uptake of a flow tracer, such as thallium-201. Theoretically, myocardial ischemia is not required for the dipyridamole-thallium test to be positive. However, dipyridamole infusion can also induce myocardial ischemia in the presence of a coronary obstruction. This has been shown by a large amount of experimental and clinical evidence . At a dosage of 0.75 mg/kg over 10 min, the electrocardiogram (ECG)-dipyridamole stress test has been proposed for the diagnosis of coronary artery disease, with a diagnostic accuracy comparable to the exercise stress test and an overall sensitivity (ECG changes and/or anginal pain) of about 80% (for a review, see ref ).
KeywordsCoronary Stenosis Exercise Stress Test Isosorbide Dinitrate Dipyridamole Infusion Coronary Reserve
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- 3.Picano, E, Simonetti I, Masini M, Lattanzi F, Marzilli M, Distante A, De Nes M, L’Abbate A (1986) Transient myocardial dysfunction during pharmacologic vasodilation as an index of reduced coronary reserve: a coronary hemodynamic and echocardiographic study. J Am Coll Cardiol 8: 84–90.PubMedCrossRefGoogle Scholar
- 8.Lattanzi F, Picano E, Masini M (1988) Safety of high dose dipyridamole echocardiography test. J Am Coll Cardiol 11 February (suppl): 217A, (abstracts).Google Scholar
- 18.Picano E, De Peri G, Salerno JA, Arbustini E, Distante A, Martinelli L, Pucci A, Montermartini C, Viganó M, Dorieto L (1990) Electrocardiographic changes suggestive of myocardial ischemic elicited by dipyridamole infusion in acute rejection only after heart transplantation. Circulation 81: 72–77.PubMedCrossRefGoogle Scholar
- 20.Picano E, Severi S, Michelassi C, Lattanzi F, Masini M, Orsini E, Distante A, L’Abbate A (1989) Prognostic importance of dipyridamole-echocardiography test in coronary artery disease 80: 450–457.Google Scholar