Dipyridamole test in angina pectoris: Diagnostic value and pathophysiological implications

L. Tavazzi, M. Previtali, J. A. Salerno, M. Chimienti, M. Ray, A. Medici, G. Specchia, P. Bobba

Research output: Contribution to journalArticlepeer-review

Abstract

The value of the dipyridamole test (0.75 mg/kg i.v.) in the diagnosis of angina pectoris was studied in 54 patients with angina pectoris (35 with angina on effort associated or not associated with rest angina and 19 with angina only at rest) and in 12 control subjects. The test induced electrocardiographic signs of ischemia (positive test) in 74% of patients with angina on effort, while it was negative in all cases with angina only at rest and in control subjects. All anginal patients with normal coronary arteries or with less than 50% stenosis had a negative test; a positive response was observed in 36, 79 and 60% of cases with one-, two- or three-vessel disease, respectively. Hemodynamic changes with a marked arteriolar vasodilatation were observed both in the negative and in the positive tests. In the positive tests no significant change of double product, blood pressure and left ventricular end-diastolic pressure occurred before ischemia appeared. The results of the study show that dipyridamole as a dianostic test in angina pectoris has a high specificity but a lower sensitivity than exercise test. The hemodynamic and electrocardiographic findings in the positive tests suggest that dipyridamole-induced ischemia is due to a flow maldistribution with selective subendocardial ischemia secondary to the coronary arteriolar dilatation caused by the drug.

Original languageEnglish
Pages (from-to)34-41
Number of pages8
JournalCardiology
Volume69
Issue number1
Publication statusPublished - 1982

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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