title: Comparison of dipyridamole-handgrip test and bicycle exercise test for thallium tomographic imaging.
abstract: Seventy-three patients with angina pectoris and 20 with atypical chest pain, who underwent coronary angiography, were examined by single-photon emission computed thallium tomography (TI-SPECT) using a combined dipyridamole-handgrip stress test. Perfusion defects were detected in 78 of 81 patients with angiographically significant coronary artery disease (CAD) (sensitivity 96%). In 9 of 12 patients without CAD, the thallium images were normal (specificity 75%). Thirty-five patients with CAD were reexamined by TI-SPECT using a dynamic bicycle exercise stress test. The sensitivity of the dipyridamole-handgrip test did not differ from the bicycle exercise test in diagnosing the CAD (97% vs 94%). Multiple thallium defects were seen in 19 of 22 (86%) patients with multivessel CAD by the dipyridamole-handgrip test but only in 14 of 22 (64%) by the bicycle exercise test. Noncardiac side-effects occurred in 17 of 93 (18%) patients after dipyridamole infusion. Cardiac symptoms were less common during the dipyridamole-handgrip test than during the bicycle exercise (15% vs 76%, p less than 0.01). These data suggest that the dipyridamole-handgrip test is a useful alternative stress method for thallium perfusion imaging, particularly in detecting multivessel CAD.
authors.affiliation: Department of Medicine, Oulu University Central Hospital, Finland.
authors.forename: H V
authors.initials: HV
authors.lastname: Huikuri
authors.forename: U R
authors.initials: UR
authors.lastname: Korhonen
authors.forename: J
authors.initials: J
authors.lastname: Airaksinen
authors.forename: M J
authors.initials: MJ
authors.lastname: Ikäheimo
authors.forename: J
authors.initials: J
authors.lastname: Heikkilä
authors.forename: J T
authors.initials: JT
authors.lastname: Takkunen
mesh_terms: D000787:Angina Pectoris / Q000175:diagnosis* / Q000000981:diagnostic imaging; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects; D004176:Dipyridamole; D005080:Exercise Test; D005260:Female; D006225:Hand; D006334:Heart Function Tests; D006801:Humans; D007537:Isometric Contraction; D008297:Male; D008875:Middle Aged; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed
chemical_list: D013794:Thallium Radioisotopes; D004176:Dipyridamole