Document Detail

Dipyridamole echocardiography stress testing in hypertensive patients. Targets and tools.
MedLine Citation:
PMID:  1827059     Owner:  NLM     Status:  MEDLINE    
Arterial hypertension can provoke a reduction in coronary flow reserve through several mechanisms that are not mutually exclusive, namely, coronary artery disease, left ventricular hypertrophy, and microvascular disease. These different targets of arterial hypertension should be explored with different diagnostic markers. The transient dyssynergy detected by two-dimensional echocardiography and evoked during dipyridamole infusion is a marker of coronary disease that is equally reliable in normotensive and hypertensive individuals. On the contrary, dipyridamole-induced ST segment depression is frequently elicited in hypertensive patients when angiographically assessed coronary disease is absent. This ischemiclike electrocardiographic response can be found in echocardiographically assessed left ventricular hypertrophy. However, even when left ventricular mass is normal, dipyridamole-induced ST segment depression is associated with an impaired coronary flow response to pacing, which is consistent with microvascular disease. Whether echocardiographically silent electrocardiographic changes are simply diagnostic noises transmitting a misleading false positive response or a potentially important clinical marker of early myocardial damage remains a pivotal though still unanswered question.
A R Lucarini; E Picano; F Lattanzi; P Camici; C Marini; A Salvetti; A L'Abbate
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  83     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1991 May 
Date Detail:
Created Date:  1991-06-06     Completed Date:  1991-06-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  III68-72     Citation Subset:  AIM; IM    
CNR Clinical Physiology Institute, University of Pisa, Italy.
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MeSH Terms
Cardiomegaly / diagnosis
Coronary Disease / diagnosis
Dipyridamole / diagnostic use*
Hypertension / diagnosis*
Vascular Diseases / diagnosis
Reg. No./Substance:

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