Dose and test for dipyridamole infusion and cardiac imaging early after uncomplicated acute myocardial infarction.
To evaluate the relation of the dose of intravenous dipyridamole on results of thallium and echocardiographic testing, the results of standard- (0.56 mg/kg/4 minutes) versus high- (0.84 mg/kg/10 minutes) dose dipyridamole were obtained 9 +/- 3 days after uncomplicated acute myocardial infarction in 57 patients. New wall motion abnormalities were compared with redistribution of thallium imaging and results of discharge coronary angiography. The sensitivity of thallium in predicting the presence of multivessel coronary artery disease was significantly (p < 0.01) higher (85%) than echocardiography (53%) and was unaffected by the dose. However the sensitivity of echocardiography was better with the higher dose (53 vs 14%). Minor adverse effects occurred in 34 patients (59%) after receiving the high dose and only in 4 patients (7%) after the standard dose (p < 0.001). Thus, thallium-201 scintigraphy during standard-dose dipyridamole infusion is more effective than high-dose dipyridamole echocardiographic testing in safely identifying patients who could benefit from early invasive evaluation and therapy.
Casanova
R
R
Cardiology Division, Ospedale per gli Infermi, Faenza, Italy.
Patroncini
A
A
Guidalotti
P L
PL
Capacci
P F
PF
Jacopi
F
F
Fabbri
M
M
Maresta
A
A
D000787:Angina Pectoris / Q000139:chemically induced; D001794:Blood Pressure / Q000187:drug effects; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D004176:Dipyridamole / Q000008:administration & dosage* / Q000009:adverse effects; D004452:Echocardiography; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects / Q000502:physiology; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015635:Radionuclide Ventriculography; D013794:Thallium Radioisotopes; D016276:Ventricular Function / Q000187:drug effects / Q000502:physiology
D013794:Thallium Radioisotopes; D004176:Dipyridamole