Open AccessAssessment of Diagnostic Value of Dipyridamole Testing in Angina Pectoris
Author(s) -
Deambroggi L.,
Barbieri P.,
Debiash A. M.,
Repetto S.,
Radice M.
Publication year - 1982
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960050402
Subject(s) - dipyridamole , medicine , coronary steal , chest pain , cardiology , angina , coronary arteries , blood pressure , rate pressure product , ischemia , anesthesia , heart rate , myocardial infarction , myocardial ischemia , artery
Summary: In order to assess the diagnostic value of dipyridamole (D) testing, we studied the responses of 34 patients with chest pain and 10 normal subjects. Blood pressure and 12‐lead ECG were recorded during and after intravenous infusion of 0.6 mg/kg dipyridamole for 10 minutes. Coronary arteriography and maximal or symptom‐limited exercise tests were performed in the 34 patients with chest pain. During infusion 13 patients presented ischemic ST changes and 5 with anginal pain only. The latter group had normal coronary arteries. Among the 13 patients with ischemic ST changes, 7 had at least two critical coronary stenoses and the remaining 6 had no coronary lesions. Dipyridamole tests showed poor sensitivity (44%) and specificity (39%) with respect to coronary arteriography. The relatively high number of positive responses in subjects with normal coronary arteries indicates that the coronary steal phenomenon is not the sole cause of “ischemic” response to the drug. Indirect indexes of myocardial oxygen consumption were higher in patients with a positive response to drug infusion than in those with a negative response; however the value of rate‐pressure product at infusion end never reached that observed at ischemic threshold during exercise testing in the same patient. This suggests that neither can oxygen consumption increase be considered as entirely responsible for ischemic response to dipyridamole. In conclusion dipyridamole test cannot be proposed for predicting critical coronary stenoses.