Limitations of dipyridamole-echocardiography in effort angina pectoris

Alberto Margonato, Sergio Chierchia, Domenico Cianflone, Gillian Smith, Filippo Crea, Graham J. Davies, Attilio Maseri, Rodney A. Foale

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Abstract

The sensitivity of dipyridamole-2-dimensional (2-D) echocardiography was assessed for detection and localization of ischemia in 21 patients with severe chronic stable angina pectoris, a clearly positive exercise stress test response and multivessel coronary atherosclerosis. Regional wall motion during dipyridamole infusion (0.6 mg/kg intravenously over 4 minutes) was compared with control and recovery by 2 blinded observers in consensus. Transient regional wall motion abnormalities were observed in 11 patients. Angina and ST-segment changes occurred in 9 of these 11 patients with positive responses, but in none of those who showed no transient abnormality of regional wall motion. Localization of regional wall motion abnormalities correlated well with angiographic severity of coronary lesions. Endocardial area contraction, evaluated by a computerized system, was reduced significantly after dipyridamole administration in patients with a positive response (from 51 ±10% to 35 ± 11%, p <0.001), whereas it did not change significantly in the others (from 43 ± 6% to 42 ± 8%). In the 11 patients with a positive response, coronary reserve assessed by exercise testing (modified Bruce protocol) was more impaired than in those with a negative response (time to 1 mm of ST depression 177 ± 148 seconds and 472 ± 179 seconds, respectively, p <0.01). In patients with severe angina and multivessel coronary artery disease, dipyridamole-2-D echocardiography appears to identify the vessel in which flow reserve is most limited. Although this information may be valuable, indications for the test are restricted to patients with severely limited exercise capacity.

Original languageEnglish
Pages (from-to)225-230
Number of pages6
JournalThe American Journal of Cardiology
Volume59
Issue number4
DOIs
Publication statusPublished - Feb 1 1987

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Dipyridamole
Angina Pectoris
Echocardiography
Stable Angina
Exercise Test
Coronary Artery Disease
Exercise
Reaction Time
Consensus
Ischemia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Limitations of dipyridamole-echocardiography in effort angina pectoris. / Margonato, Alberto; Chierchia, Sergio; Cianflone, Domenico; Smith, Gillian; Crea, Filippo; Davies, Graham J.; Maseri, Attilio; Foale, Rodney A.

In: The American Journal of Cardiology, Vol. 59, No. 4, 01.02.1987, p. 225-230.

Research output: Contribution to journalArticle

Margonato, Alberto ; Chierchia, Sergio ; Cianflone, Domenico ; Smith, Gillian ; Crea, Filippo ; Davies, Graham J. ; Maseri, Attilio ; Foale, Rodney A. / Limitations of dipyridamole-echocardiography in effort angina pectoris. In: The American Journal of Cardiology. 1987 ; Vol. 59, No. 4. pp. 225-230.
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