title: [Doppler echocardiography under dipyridamole after thrombolyzed early myocardial infarction. Comparison with coronarographic data].
abstract: The reliability and safety of Doppler echocardiography with dipyridamole (0.84 mg/kg in 10 min) were evaluated in 63 patients an average of 7 days after a thrombolysed early lateral infarct and 24 hours before follow-up coronary arteriography. The aims of the test were the detection of tight stenoses (diameter reduced by more than 75%) affecting the artery responsible for the infarct as well as the other coronary vessels, using the vasodilator action of dipyridamole. The echocardiographic manifestation of induced coronary steal consisted of transitory asynergism in the territory of the artery involved. Clinical tolerability of the test was good. The brief onset of anginal pain was nevertheless seen in 6 patients. Analysis of the zone corresponding to the necrosed area was possible in only 43 cases. Sensitivity of the test for detection of a post-infarction residual stenosis was 64% (39-89) and specificity 90% (79-100). Study of other territories was possible in 59 cases. Sensitivity of the test for the diagnosis of multiple vessel disease was 70% (42-98) and specificity 94% (88-100). In the population as a whole, Doppler study of variations in anterograde mitral flow revealed a sensitivity of 40% (27-53) and specificity of 87% (78-96). Variations in sub-aortic flow were analysed only in the final 27 patients, with a sensitivity and specificity of 100%. The specificity of dipyridamole echocardiography after infarction is good, both for the detection of residual stenosis and that of multiple vessel disease, the chief limiting factor being the impossibility of analysis of the infarcted region in the presence of initial akinesis.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Service de Cardiologie, Hôpital R. Debré, Reims.
authors.forename: D
authors.initials: D
authors.lastname: Metz
authors.forename: J L
authors.initials: JL
authors.lastname: Pommier
authors.forename: P
authors.initials: P
authors.lastname: Nazeyrollas
authors.forename: L
authors.initials: L
authors.lastname: Chapoutot
authors.forename: J
authors.initials: J
authors.lastname: Graciet
authors.forename: J P
authors.initials: JP
authors.lastname: Chabert
authors.forename: J
authors.initials: J
authors.lastname: Elaerts
authors.forename: A
authors.initials: A
authors.lastname: Bajolet
mesh_terms: D000328:Adult; D003251:Constriction, Pathologic; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000517:prevention & control; D004176:Dipyridamole; D015150:Echocardiography, Doppler; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000188:drug therapy
chemical_list: D004176:Dipyridamole
vernacular_title: Echocardiographie Doppler sous dipyridamole après infarctus du myocarde inaugural thrombolysé. Comparaison aux données de la coronarographie.