title: Effect of chronic sustained-release dipyridamole on myocardial blood flow and left ventricular function in patients with ischemic cardiomyopathy.
abstract: Dipyridamole increases adenosine levels and augments coronary collateralization in patients with coronary ischemia. This pilot study tested whether a 6-month course of sustained-release dipyridamole/aspirin improves coronary flow reserve and left ventricular systolic function in patients with ischemic cardiomyopathy. Six outpatients with coronary artery disease and left ventricular ejection fraction (LVEF) <40% were treated with sustained-release dipyridamole 200 mg/aspirin 25 mg twice daily for 6 months. Myocardial function and perfusion, including coronary sinus flow at rest and during intravenous dipyridamole-induced hyperemia, were measured using velocity-encoded cine magnetic resonance stress perfusion studies at baseline, 3 months, and 6 months. There was no change in heart failure or angina class at 6 months. LVEF increased by 39%+/-64% (31.0%+/-13.3% at baseline vs 38.3%+/-10.7% at 6 months; P=.01), hyperemic coronary sinus flow increased more than 2-fold (219.6+/-121.3 mL/min vs 509.4+/-349.3 mL/min; P=.01), and stress-induced relative myocardial perfusion increased by 35%+/-13% (9.4%+/-3.4% vs 13.9%+/-8.5%; P=.004). Sustained-release dipyridamole improved hyperemic myocardial blood flow and left ventricular systolic function in patients with ischemic cardiomyopathy.
authors.affiliation: Department of Medicine, Division of Cardiology, University of California at San Francisco, San Francisco, CA, USA.
authors.forename: Mateen
authors.initials: M
authors.lastname: Akhtar
authors.forename: Karen
authors.initials: K
authors.lastname: Ordovas
authors.forename: Alastair
authors.initials: A
authors.lastname: Martin
authors.forename: Charles B
authors.initials: CB
authors.lastname: Higgins
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Michaels
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity / Q000187:drug effects; D009202:Cardiomyopathies / Q000188:drug therapy* / Q000503:physiopathology*; D003326:Coronary Circulation / Q000187:drug effects*; D023921:Coronary Stenosis / Q000188:drug therapy / Q000503:physiopathology; D004176:Dipyridamole / Q000378:metabolism / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000188:drug therapy* / Q000503:physiopathology*; D010865:Pilot Projects; D012107:Research Design; D013318:Stroke Volume / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects*
chemical_list: D004176:Dipyridamole