title: Comparison of usefulness of high-dose dipyridamole echocardiography and exercise electrocardiography for detection of asymptomatic restenosis after coronary angioplasty.
abstract: The present study compares the relative usefulness of the maximal treadmill exercise electrocardiography test with the high-dose dipyridamole echocardiography test (echocardiographic monitoring during dipyridamole infusion up to 0.84 mg/kg in 10 minutes) in detecting severe restenosis or coronary artery disease progression (greater than 70% stenosis) in asymptomatic patients 12 months after a primary successful coronary angioplasty. Criteria of positivity were: for the exercise electrocardiography test, an ST-segment shift greater than or equal to 0.1 mV from baseline, 0.08 second from the J point; for the dipyridamole echocardiography test, a transient dyssynergy of contraction, absent or of a lesser degree than that in the baseline examination. The exercise electrocardiography and dipyridamole echocardiography tests revealed a similar feasibility (91 vs 87%, difference not significant). Both tests could be performed in 75 patients. For detection of restenosis or disease progression, or both, the exercise electrocardiography test revealed a sensitivity similar to the dipyridamole echocardiography test (71 vs 71%, difference not significant), but a lower specificity (61 vs 90%). It is concluded that the high-dose dipyridamole echocardiography test is equally feasible but more accurate than the exercise electrocardiography test for noninvasive detection of severe asymptomatic restenosis or disease progression at 1 year after successful coronary angioplasty.
authors.affiliation: Department of Cardiology, Niguarda Hospital, Milano, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Pirelli
authors.forename: G B
authors.initials: GB
authors.lastname: Danzi
authors.forename: A
authors.initials: A
authors.lastname: Alberti
authors.forename: D
authors.initials: D
authors.lastname: Massa
authors.forename: G
authors.initials: G
authors.lastname: Piccaló
authors.forename: F
authors.initials: F
authors.lastname: Faletra
authors.forename: E
authors.initials: E
authors.lastname: Picano
authors.forename: L
authors.initials: L
authors.lastname: Campolo
authors.forename: C
authors.initials: C
authors.lastname: De Vita
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis* / Q000628:therapy; D004176:Dipyridamole; D004452:Echocardiography; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012680:Sensitivity and Specificity
chemical_list: D004176:Dipyridamole