[Myocardial ischemia caused by the injection of dipyridamole followed by low level exertion on an exercise bicycle].
The purpose of this study was the feasibility, safety and analysis of the ischemic nature of the association of an injection of dipyridamole and an exercise test at low level exertion on an exercise bicycle for 4 minutes. The ischemic nature of this combination was assessed on the basis of three criteria: the onset of angina-type pain, electrical changes and scintigraphic abnormalities. The test could be carried out by all patients and the most common adverse events were headache (6.5%) and heartburn (3.5%). The 17 patients in this study who had one or more stenoses in excess of 70% presented with angina-type pain (3/17); electrical abnormalities (9/17) and scintigraphic abnormalities in all cases. Of the six patients who had lesions between 50 and 70%, 1 presented with angina symptoms, 2 with electrical abnormalities and 5 with scintigraphic abnormalities. Seven patients in this study showed no significant lesions when subjected to coronary artery angiography. However, angina-type pain and electrical signs were observed in 2 cases and one false positive result by scintigraphy. This study shows that it is possible to combine the injection of dipyridamole with an exercise test involving a low level of exertion on an exercise bicycle which gives a good diagnostic value to the CT scan. The frequency of clinical and electrical signs of ischemia makes it necessary to take the same precautions as for a peak exercise test.
Cottin
Y
Y
Centre de Cardiologie, Hôpital du Bocage, CHU, Dijon.
Morelon
P
P
André
F
F
Touzery
C
C
Brunotte
F
F
Wolf
J E
JE
Louis
P
P
D000368:Aged; D003327:Coronary Disease / Q000139:chemically induced / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004176:Dipyridamole / Q000009:adverse effects; D005080:Exercise Test / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D011877:Radionuclide Imaging
D004176:Dipyridamole
Ischémie myocardique induite par l'injection de dipyridamole suivie d'un effort à faible puissance sur bicyclette ergométrique.