Two‐dimensional echocardiographic evaluation of ventricular asynergy induced by dipyridamole: Correlation with thallium scanning

Ferrara, Nicola; Bonaduce, Domenico; Leosco, Dario; Longobardi, Giancarlo; Abete, Pasquale; Morgano, G; Salvatore, Marco; Rengo, Franco

doi:10.1002/clc.4960090910

Cited by 37 publications

(7 citation statements)

References 23 publications

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“…Furthermore, in this study a relatively large number of CAD patients (10 of 30) had single-vessel disease. In comparative studies on the same patient population, the DET sensitivity was similar to that for exercise-thallium scintigraphy, 15 dipyridamole-thallium scintigraphy, 16 and exercise echocardiography. 17 The main limitation of the DET is the requirement of an acceptable acoustic window, which is found in more than 90% of patients with state of the art echocardiographic instruments.…”

Section: Discussionmentioning

confidence: 56%

Dipyridamole echocardiography in essential hypertensive patients with chest pain.

et al. 1988

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SUMMARYThe exerdse-electrocardiography test shows limited feasibility and diagnostic accuracy for the ooninvaslve detection of coronary artery disease hi hypertensive patients. Recently, the dipyridamoleechocardiography test (two-dimensional echocardtographic monitoring with dipyridamole infusion, up to 0.84 mg/kg over 10 minutes) has been proposed as an exercise-independent method for the diagnosis of coronary artery disease. The diagnostic usefulness of the exerdse-electrocardiography test and the dipyridamole-echocardiography test was evaluated in 63 consecutive inpatients with history of chest pain, essential hypertension, and no previous myocardial infarction. The criterion of posltlvity for the exerdse-electrocardiography test was a horizontal or downsioping ST segment shift exceeding 0.1 mV and for the dipyridamole-echocardiography test, a transient dyssynergy of contraction. Fifteen patients could not perform a diagnostic exerdse-electrocardiography test because of an nubility to exercise adequately (two patients), severe hypertension hi spite of full antihypertensive therapy (six patients), or excessive blood pressure rise at the first step of the exercise-electrocardiography test (seven patients). Five patients could not perform the dipyridamole-echocardiography test because of a poor acoustic window. The overall feasibility was 76% for the exercise-electrocardiography test and 92% for the dipyridamoleechocardiography test (p < 0.05). All 43 patients who performed both tests underwent coronary angiography; 30 had significant coronary artery disease (>70% lumen reduction of at least 1 major coronary vessel). Sensitivity was 67% for both the exercise-electrocardiography test and the dipyridamoleechocardiography test (p = NS); spedfidty was 46% for the exerdse-electrocardiography test and 92% for the dipyridamole-echocardiography test {p < 0.05). Thus, the dipyridamole-echocardiography test represents a good diagnostic alternative to the exercise-electrocardiography test hi symptomatic hypertensive patients, as it has a similar sensitivity and higher feasibility and spedfidty for the detection of coronary artery disease.

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Section: Discussionmentioning

confidence: 56%

Dipyridamole echocardiography in essential hypertensive patients with chest pain.

et al. 1988

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“…In a previous study we compared the diagnostic potential of dipyridamole echocardiography and 201‐Thallium scintigraphy 6 . This study demonstrated that ventricular asynergies detected by two‐dimensional echocardiography during dipyridamole infusion are closely correlated with the site of myocardial perfusion defects at thallium scanning and with the presence of significant coronary artery stenoses at angiography.…”

Section: Discussionmentioning

confidence: 86%

“…Recently, the dipyridamole‐echocardiography test, alone or associated with 12‐lead electrocardiographic monitoring, has been proposed for detecting coronary artery disease and is reported to have good sensitivity and specificity 6 , 7 . In particular, Picano et al 8 compared high‐dose dipyridamole echocardiography and exercise electrocardiography tests in patients with effort angina pectoris and found the former to have higher specificity (100% vs 71%) and similar sensitivity (74% vs 69%).…”

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confidence: 99%

Dipyridamole Echocardiography as a Useful and Safe Test in the Assessment of Coronary Artery Disease in the Elderly

Ferrara¹,

Leosco²,

Abete³

et al. 1991

J American Geriatrics Society

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We prospectively studied the sensitivity, specificity, feasibility, and safety of high-dose dipyridamole echocardiography, compared to exercise electrocardiography in 130 subjects (67 younger and 63 elderly patients) referred for angiographic evaluation of suspected or proven coronary artery disease. Sensitivity, specificity, and feasibility of dipyridamole echocardiography were respectively 75.5%, 100%, and 88.0% in younger patients and 82.9%, 100%, and 79.4% in elderly patients (P = NS). The sensitivity of exercise electrocardiography was 72.7% in young and 66.6% in elderly patients (P = NS); specificity 66.0% vs 60.0% (P = NS); feasibility 83.6 vs 63.5 (P = 0.05). Forty-nine younger and 38 elderly patients performed both tests. Sensitivity of dipyridamole echocardiography compared to exercise electrocardiography was 76.2% vs 73.8% in young patients and 83.3% vs 70% in the older group (P = NS). The feasibility of the two tests was significantly different in the elderly group only (dipyridamole echocardiography 79.4% vs exercise electrocardiography 63.5%; P less than 0.01). The incidence of side effects during dipyridamole echocardiography was similar in the two groups, except for dyspnea which was observed in 20% of older and 5% of younger patients (P less than 0.05). Our data demonstrate that the dipyridamole test combined with echocardiographic monitoring of regional myocardial contractility may be considered a valid non-invasive method for evaluating coronary artery disease in the elderly and that this test is a satisfactory alternative to the exercise stress test.

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“…It has been shown that dipyridamole stress echocardiography has lower sensitivity and higher specificity compared with dipyridamole stress myocardial perfusion scintigraphy. [13][14][15][16][17] Dagianti, et al and Casanova, et al showed that the sensitivity of dipyridamole stress echocardiography was 52% and 53%, respectively. 18,19) However, the specificity of dipyridamole echocardiography has been reported to be excellent even in challenging subsets of patients in whom the rate of false-positive responses was higher with electrocardiographic or scintigraphic techniques, such as hypertensive patients.…”

Section: A B Discussionmentioning

confidence: 99%

<b>Dipyridamole Stress Echocardiography and Ultrasonic Myocardial Tissue Characterization in Predicting Myocardial Ischemia, in Comparison With Dipyridamole Stress Tc-99m MIBI SPECT Myocardial Imaging</b>

et al. 2004

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SUMMARYThe purpose of this study was to validate whether dipyridamole stress ultrasonic tissue characterization with cyclic variation of integrated backscatter (CVIBS) compared with dipyridamole stress echocardiography and dipyridamole stress Tc99m-MIBI SPECT myocardial perfusion scintigraphy could predict myocardial ischemia in patients with chronic coronary artery disease.Twenty patients (16 M, 4 F) who had coronary angiography for stable angina pectoris were included in the study. Mean age was 62 ± 8 years. The left ventricle was divided into 16 segments. Regional wall motion analysis and CVIBS measurements were obtained from 16 myocardial segments at rest and after dipyridamole (0.84 mg/kg) infusion. After 10 minutes, Tc-99m MIBI (10 mCi) was injected and SPECT myocardial imaging was performed. After 3 hours, 25 mCi Tc-99m MIBI was reinjected and rest images were obtained.A total of 320 ventricular wall segments were evaluated. Two hundred and six ventricular wall segments were supplied by stenotic coronary arteries and 114 segments were supplied by normal coronary arteries. Dipyridamole stress Tc-99m MIBI SPECT studies showed abnormal myocardial perfusion in 176 segments and normal perfusion in 144 segments. Transient regional wall motion abnormality was detected in 116 segments. A significant decrease in CVIBS after dipyridamole stress was detected in 184 segments. The sensitivity and specificity of dipyridamole stress echocardiography, Tc-99m MIBI SPECT, and CVIBS were 56% and 100%, 85% and 92%, and 89% and 100%, respectively, compared with the results from coronary angiography.Dipyridamole stress ultrasonic tissue characterization with CVIBS may provide more sensitive detection of myocardial ischemia than dipyridamole stress echocardiography and may be as valuable as dipyridamole stress myocardial perfusion scintigraphy. (Jpn Heart J 2004; 45: 937-948)

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Two‐dimensional echocardiographic evaluation of ventricular asynergy induced by dipyridamole: Correlation with thallium scanning

Cited by 37 publications

References 23 publications

Dipyridamole echocardiography in essential hypertensive patients with chest pain.

Dipyridamole echocardiography in essential hypertensive patients with chest pain.

Dipyridamole Echocardiography as a Useful and Safe Test in the Assessment of Coronary Artery Disease in the Elderly

<b>Dipyridamole Stress Echocardiography and Ultrasonic Myocardial Tissue Characterization in Predicting Myocardial Ischemia, in Comparison With Dipyridamole Stress Tc-99m MIBI SPECT Myocardial Imaging</b>

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