[Diagnostic value of echocardiography with dipyridamole in coronary disease and evaluation of its prognostic potentiality face to ergometry, plane dipyridamole Tc99m-MIBI myocardial perfusion scintigraphy and coronary cineangiography].
OBJECTIVE
To assess in a consecutive series of patients, the diagnostic accuracy of dipyridamole echocardiography and to compare its prognostic power with that from other tests.


METHODS
Seventy eight patients prospectively were underwent to dipyridamole echocardiography (DET) and coronary arteriography for diagnostic and post-infarction investigation. The majority was underwent to treadmill stress test and Tc99MIBI-dipyridamole planar myocardial scintigraphy. Eleven variables with possible prognostic importance were analyzed in a stepwise model to identify independent predictors of events.


RESULTS
Sensitivity and specificity for the presence of coronary artery disease (in non-M patients) and multivessel disease (in post-MI patients) were, respectively, 44%, 91%, 53% and 88%. Mean follow-up was 21 +/- 9 months, during which there were four deaths, four unstable angina episodes, four nonfatal myocardial infarctions and eight revascularization procedures. By multivariate analysis, the only independent predictor of events was the change in wall motion score index from rest to peak stress.


CONCLUSIONS
DET is a valuable alternative to exercise stress test and myocardial perfusion scintigraphy. Semiquantitative estimation of ischemic area during pharmacological stress is an important prognostic marker.
Kaiser
S E
SE
Escola Médica de Pós-Graduação da PUC do Rio de Janeiro e Hospital Central do IASERJ.
Bueno
M S
MS
Pedras
I V
IV
de Freitas
E V
EV
de la Nuez
S B
SB
Luna
R L
RL
D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis*; D004176:Dipyridamole; D004452:Echocardiography / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011875:Radionuclide Angiography; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D014665:Vasodilator Agents
D014665:Vasodilator Agents; D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi
Valor diagnóstico da ecocardiografia com dipiridamol em doença coronária e avaliação de sua potencialidade prognóstica frente à ergometria, cintigrafia de perfusão miocárdica planar com dipiridamol e Tc99m-MIBI e cinecoronariografia.