title: Transesophageal dipyridamole echocardiography for diagnosis of coronary artery disease.
abstract: The value of transthoracic dipyridamole echocardiography has been extensively documented. However, in some patients, because of a poor acoustic window, the rest transthoracic examination is not always feasible and the transesophageal approach is more convenient. Therefore, transesophageal echocardiography with high dose dipyridamole (up to 0.84 mg/kg body weight over 10 min) was performed in 32 patients in whom the transthoracic dipyridamole test either was not feasible (n = 29) or yielded ambiguous results (n = 3). The transesophageal echocardiographic test results were considered abnormal when new dipyridamole-induced regional wall motion abnormalities were observed. All 32 patients underwent coronary angiography; significant coronary artery disease was defined as greater than or equal to 70% lumen diameter narrowing in at least one major vessel. All patients also performed a bicycle exercise test 1 day before transesophageal dipyridamole echocardiography. Transesophageal stress studies were completed in all patients, with a maximal imaging time (in tests with a negative result) of 20 min. No side effects or intolerance to drug or transducer was observed. The left ventricle was always visualized in the four-chamber and transgastric short-axis views. High quality two-dimensional echocardiographic images were obtained in all patients both at rest and at peak dipyridamole infusion and were digitally analyzed in a quad-screen format. Coronary angiography showed coronary artery obstruction in 24 patients: 6 had single-, 9 double- and 9 triple-vessel disease. The transesophageal dipyridamole test showed a specificity of 100% and an overall sensitivity of 92%. The sensitivity of this test for single-, double- and triple-vessel disease was 67%, 100% and 100%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Cardiology, La Sapienza, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Agati
authors.forename: M
authors.initials: M
authors.lastname: Renzi
authors.forename: S
authors.initials: S
authors.lastname: Sciomer
authors.forename: D C
authors.initials: DC
authors.lastname: Vizza
authors.forename: P
authors.initials: P
authors.lastname: Voci
authors.forename: M
authors.initials: M
authors.lastname: Penco
authors.forename: F
authors.initials: F
authors.lastname: Fedele
authors.forename: A
authors.initials: A
authors.lastname: Dagianti
mesh_terms: D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000000981:diagnostic imaging*; D004176:Dipyridamole; D004452:Echocardiography / Q000379:methods*; D005080:Exercise Test; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D012680:Sensitivity and Specificity
chemical_list: D004176:Dipyridamole