Dipyridamole myocardial perfusion tomography in patients with severe aortic stenosis. | |
MedLine Citation:
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PMID: 11893828 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Patients with aortic stenosis (AS) may have classic angina pectoris. The safety of exercise testing in adults with AS is controversial and, in fact, exercise testing in such patients is considered to be contraindicated especially in severe aortic stenosis (SAS). Furthermore, exercise testing has low specificity in uncovering coronary artery disease (CAD) in patients with AS, because the baseline ECG is frequently abnormal. We wished to assess the safety and diagnostic accuracy of dipyridamole stress myocardial perfusion tomography (DMPT) in the detection of CAD in patients with SAS. METHODS: The study included 30 patients with SAS (mean aortic valve area 0.57 +/- 0.09 cm(2)). All patients underwent dipyridamole myocardial perfusion scintigraphy (SPECT), coronary arteriography and catheterization, as well as Doppler echocardiography. Myocardial perfusion tomography was applied with (99m)Tc hexakis-2-methoxyisobutyl isonitrile (MIBI) by a single day rest-dipyridamole infusion protocol. Hemodynamic, electrocardiographic and clinical responses were compared with those of 50 control patients without AS. RESULTS: Hemodynamic responses during dipyridamole stress tests demonstrated no significant differences between the controls and the AS patients in the following parameters: systolic blood pressure, heart rate, rate-pressure product or incidence of headache, chest pain, dyspnea, flushing and dizziness. A reversible perfusion defect was observed in 10 patients with DMPT. The existence of coronary lesions was determined by coronary arteriography in 8 of 10 patients (sensitivity 100%, specificity 91%). CONCLUSION: The results showed that DMPT is well tolerated, even by patients with SAS and is of high diagnostic value in assessing CAD. |
Authors:
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Mehmet Onur Demirkol; Bengi Yaymaci; Hakan Debeş; Yelda Başaran; Fikret Turan |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Cardiology Volume: 97 ISSN: 0008-6312 ISO Abbreviation: Cardiology Publication Date: 2002 |
Date Detail:
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Created Date: 2002-03-14 Completed Date: 2002-04-25 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1266406 Medline TA: Cardiology Country: Switzerland |
Other Details:
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Languages: eng Pagination: 37-42 Citation Subset: IM |
Copyright Information:
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Copyright 2002 S. Karger AG, Basel |
Affiliation:
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Department of Nuclear Medicine, Koşuyolu Heart and Research Hospital, Istanbul, Turkey. onurdemirkol@hotmail.com |
Export Citation:
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MeSH Terms | |
Descriptor/Qualifier:
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Aged Aortic Valve Stenosis / complications*, physiopathology* Coronary Angiography Coronary Artery Disease / diagnosis*, etiology*, physiopathology Coronary Circulation / physiology Dipyridamole / adverse effects*, diagnostic use* Echocardiography Exercise Test / adverse effects* Female Hemodynamics / physiology Humans Male Middle Aged Perfusion / adverse effects* Phosphodiesterase Inhibitors / adverse effects*, diagnostic use* Sensitivity and Specificity Severity of Illness Index Tomography / adverse effects* Tomography, Emission-Computed, Single-Photon |
Chemical | |
Reg. No./Substance:
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0/Phosphodiesterase Inhibitors; 58-32-2/Dipyridamole |
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