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To determine whether dipyridamole infusion can be used as an alternative method to physical exercise, 87 lead body surface mapping was performed to compare the distribution patterns of ST-segment depression after 0.568 mg/kg/4 min dipyridamole infusion (D) and after submaximal treadmill exercise (T) in 21 patients with coronary artery disease. Significant ST-segment depression (greater than or equal to 0.05 mV) was observed in 19 patients after D and in 18 after T. After D and T, each patient showed a similar distribution pattern of ST-segment depression. There were no significant differences in the number of leads which showed ST-segment depression (nST: D, 15.6 +/- 11.1 vs T, 15.2 +/- 10.8) and in the maximal value of ST-segment depression (STmax: D, -0.24 +/- 0.16 vs T, -0.20 +/- 0.13 mV). Good correlations were observed in nST (r = 0.84) and in STmax (r = 0.87) between D and T. The increase in mean pressure-rate product after T was 89%, while the increase after D was only 22%. Our results suggest that this pharmacologic test to induce myocardial ischemia may be useful in the evaluation of coronary artery disease in patients who are physically unable to perform adequate exercise.

Comparison of the electrocardiographic changes induced by dipyridamole infusion and treadmill exercise in patients with coronary artery disease.