The association of dipyridamole side effects with hemodynamic parameters, ECG findings, and scintigraphy outcomes.
Dipyridamole has extensively been administered as a substitute for physical activity in cardiovascular assessment. The aim of this study was to evaluate the association of dipyridamole side effects with hemodynamic oscillations, scanning results, and electrocardiography (ECG) findings.


METHODS
Overall, 590 patients referred to the nuclear medicine center for myocardial perfusion imaging were evaluated for adverse dipyridamole effects concurrent with a low level of exercise. Before and during dipyridamole infusion, the patients' vital signs, electrocardiogram, heart rate, systolic blood pressure, and diastolic blood pressure were monitored; all patients underwent stress-rest (99m)Tc-sestamibi gated SPECT using a 2-d protocol.


RESULTS
Eighty-eight patients (14.9%) experienced at least one side effect during dipyridamole infusion, and abnormal ECG and scan results were observed in 32.4% and 48.6% of patients, respectively. We observed a positive correlation between a higher incidence of chest discomfort, headache, and dyspnea and abnormalities on ECG and myocardial perfusion imaging. In addition, these 3 side effects were also associated with a higher postinfusion heart rate, lower preinfusion systolic blood pressure, and lower postinfusion diastolic blood pressure. There were significant differences between pre- and postinfusion heart rate, preinfusion systolic blood pressure, and postinfusion diastolic blood pressure among patients with or without side effects, whereas no significant difference was observed in any of the hemodynamic parameters between patients with normal and abnormal ECG results or myocardial perfusion imaging results.


CONCLUSIONS
This study demonstrated a correlation between hemodynamic variables and side effects but not with imaging findings or ECG findings.
Javadi
Hamid
H
Department of Nuclear Medicine, 5th Azar Hospital, Golestan University of Medical Science, Gorgan, Iran.
Shariati
Malihnaz
M
Mogharrabi
Mehdi
M
Asli
Isa Neshandar
IN
Jallalat
Sara
S
Hooman
Aref
A
Seyedabadi
Mohammad
M
Assadi
Majid
M
D000368:Aged; D016477:Artifacts; D004176:Dipyridamole / Q000009:adverse effects*; D004562:Electrocardiography; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008875:Middle Aged; D011877:Radionuclide Imaging
D004176:Dipyridamole