title: Usefulness of the dipyridamole-Doppler test for diagnosis of coronary artery disease.
abstract: Two-dimensional and Doppler echocardiographic studies and a hemodynamic investigation were performed during dipyridamole testing in 42 subjects (13 control subjects and 29 patients with coronary artery disease [CAD]), to evaluate the ability of dipyridamole Doppler echocardiography in identifying patients with ischemic left ventricular dysfunction. In the control group, after dipyridamole infusion, Doppler-derived parameters increased significantly from baseline (p less than 0.001). In patients with CAD, peak flow velocity, flow velocity integral and stroke volume failed to increase after dipyridamole infusion (0.89 +/- 0.21 to 0.85 +/- 0.18 m/s, difference not significant; 14 +/- 3 to 12 +/- 4 cm, difference not significant, and 56 +/- 13 to 50 +/- 14 ml/beat, p less than 0.05, respectively). Heart rate, rate pressure product, systemic vascular resistance and mean right atrial pressure had similar variations in the 2 groups. Changes in the 3 Doppler-derived parameters are closely related to the variations of peak positive dP/dt, stroke volume (thermodilution) and left ventricular end-diastolic pressure and are closely related to the coronary angiography jeopardy score and to the appearance of wall motion abnormalities. Thus, by combining Doppler and 2-dimensional echocardiography, dipyridamole-induced myocardial ischemia may be detected in a high percentage of CAD patients, providing a sensitive tool for identifying patients with high-risk coronary artery anatomy.
authors.affiliation: First Department of Cardiology, La Sapienza, Roma, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Agati
authors.forename: L
authors.initials: L
authors.lastname: Arata
authors.forename: C P
authors.initials: CP
authors.lastname: Neja
authors.forename: C
authors.initials: C
authors.lastname: Manzara
authors.forename: C
authors.initials: C
authors.lastname: Iacoboni
authors.forename: C D
authors.initials: CD
authors.lastname: Vizza
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: D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis* / Q000503:physiopathology; D004176:Dipyridamole; D004452:Echocardiography; D015150:Echocardiography, Doppler; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation
chemical_list: D004176:Dipyridamole