title: Influence of dipyridamole stress echocardiography on galectin-3, amino-terminal B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T.
abstract: OBJECTIVE
  Non-invasive assessment using a pharmacological provocative test is an essential part of the workup of patients admitted to the emergency department with chest pain. Some doubts, however, remain about the safety of dipyridamole stress echocardiography in patients with non-diagnostic troponin and ECG.
  
  
  RESULTS
  Twenty-nine consecutive patients admitted to the emergency department with chest pain and no evidence of acute coronary syndrome were subjected to standard dipyridamole stress echocardiography. Blood samples for measurement of galectin-3, NT-proBNP and high-sensitivity troponin T (HS-TnT) were collected at the baseline and after provocative testing. The provocative test was positive in 7/29 patients. As compared with baseline measurements, no significant differences were observed in 1-h values of HS-TnT (10.7 versus 10.5 ng/L; P = 0.085) and galectin-3 (14.3 versus 13.7 ng/mL; P = 0.128), whereas values of NT-proBNP were slightly higher (126 versus 111 ng/L; P = 0.002). The 1-h delta variation of patients with a positive provocative test was significantly higher than that of patients with negative provocative testing for galectin-3 (1.12 versus 1.00; P < 0.001), but not for HS-TnT (0.98 versus 1.00; P = 0.184) and NT-proBNP (1.10 versus 1.04; P = 0.344). The 1-h delta variation of galectin-3 was > 1 in all patients with a positive provocative test as compared with 50% of patients with a negative provocative test (P = 0.018).
  
  
  CONCLUSIONS
  Dipyridamole stress testing did not trigger clinically meaningful injuries to the myocardium. Galectin-3 testing may hence be preliminarily regarded as a complementary means for enhancing the diagnostic value of provocative testing. It is also worthwhile investigating whether patients with abnormal response to a provocative test and increased galectin-3 values may be targeted with specific therapy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lippi
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Salvagno
authors.forename: Fiorenza
authors.initials: F
authors.lastname: Robuschi
authors.forename: Francesco
authors.initials: F
authors.lastname: Scioscioli
authors.forename: Livia
authors.initials: L
authors.lastname: Ruffini
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Cervellin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002637:Chest Pain / Q000097:blood; D004176:Dipyridamole; D025401:Echocardiography, Stress / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D037502:Galectin 3 / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000175:diagnosis*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D020107:Troponin T / Q000097:blood*; D014665:Vasodilator Agents
chemical_list: D015415:Biomarkers; D037502:Galectin 3; D010446:Peptide Fragments; D020107:Troponin T; D014665:Vasodilator Agents; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D004176:Dipyridamole