Usefulness of the dipyridamole-Doppler test for diagnosis of coronary artery disease

L Agati, L Arata, CP Neja, C Manzara… - The American journal of …, 1990 - Elsevier
L Agati, L Arata, CP Neja, C Manzara, C Iacoboni, CD Vizza, M Penco, F Fedele, A Dagianti
The American journal of cardiology, 1990Elsevier
Two-dimensional and Doppler echocardiographic studies and a hemodynamic investigation
were performed during dipyridamole testing in 42 subjects (13 control subjects and 29
patients with coronary artery disease [CAD]), to evaluate the ability of dipyridamole Doppler
echocardiography in identifying patients with ischemic left ventricular dysfunction. In the
control group, after dipyridamole infusion, Doppler-derived parameters increased
significantly from baseline (p< 0.001). In patients with CAD, peak flow velocity, flow velocity …
Two-dimensional and Doppler echocardiographic studies and a hemodynamic investigation were performed during dipyridamole testing in 42 subjects (13 control subjects and 29 patients with coronary artery disease [CAD]), to evaluate the ability of dipyridamole Doppler echocardiography in identifying patients with ischemic left ventricular dysfunction. In the control group, after dipyridamole infusion, Doppler-derived parameters increased significantly from baseline (p< 0.001). In patients with CAD, peak flow velocity, flow velocity integral and stroke volume failed to increase after dipyridamole infusion (0.89±0.21 to 0.85±0.18 m/s, difference not significant; 14±3 to 12±4 cm, difference not significant, and 56±13 to 50±14 ml/beat, p< 0.05, respectively). Heart rate, rate pressure product, systemic vascular resistance and mean right atrial pressure had similar variations in the 2 groups. Changes in the 3 Doppler-derived parameters are closely related to the variations of peak positive dP dt, stroke volume (thermodilution) and left ventricular end-diastolic pressure and are closely related to the coronary angiography jeopardy score and to the appearance of wall motion abnormalities. Thus, by combining Doppler and 2-dimensional echocardiography, dipyridamole-induced myocardial ischemia may be detected in a high percentage of CAD patients, providing a sensitive tool for identifying patients with high-risk coronary artery anatomy.
Elsevier
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