Document Detail

Dipyridamole myocardial perfusion tomography in patients with severe aortic stenosis.
MedLine Citation:
PMID:  11893828     Owner:  NLM     Status:  MEDLINE    
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.
Mehmet Onur Demirkol; Bengi Yaymaci; Hakan Debeş; Yelda Başaran; Fikret Turan
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Cardiology     Volume:  97     ISSN:  0008-6312     ISO Abbreviation:  Cardiology     Publication Date:  2002  
Date Detail:
Created Date:  2002-03-14     Completed Date:  2002-04-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  37-42     Citation Subset:  IM    
Copyright Information:
Copyright 2002 S. Karger AG, Basel
Department of Nuclear Medicine, Koşuyolu Heart and Research Hospital, Istanbul, Turkey.
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MeSH Terms
Aortic Valve Stenosis / complications*,  physiopathology*
Coronary Angiography
Coronary Artery Disease / diagnosis*,  etiology*,  physiopathology
Coronary Circulation / physiology
Dipyridamole / adverse effects*,  diagnostic use*
Exercise Test / adverse effects*
Hemodynamics / physiology
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
Reg. No./Substance:
0/Phosphodiesterase Inhibitors; 58-32-2/Dipyridamole

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