| Safety and clinical utility of combined intravenous dipyridamole/symptom-limited exercise stress test with thallium-201 imaging in patients with known or suspected coronary artery disease. | |
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MedLine Citation:
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PMID: 8254386 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Dipyridamole-induced coronary hyperemia with 201Tl myocardial perfusion scintigraphy can detect ischemic regions in individuals unable to perform adequate exercise, but it has several limitations. Symptom-limited exercise supplementation to intravenous dipyridamole can potentially overcome them, but the safety and diagnostic accuracy for this combination has not been established. Between 1987 and 1991, 441 consecutive patients were assessed for combined symptom-limited exercise test preceded by i.v. dipyridamole. Clinical records could not be obtained for 37 patients, and 40 patients were not exercised because they were unable; therefore 384 patients (mean age 58 +/- 9.8 yr, 278 men) underwent symptom-limited exercise preceded by 0.56 mg/kg of dipyridamole and followed by planar 201Tl perfusion scintigraphy. Following dipyridamole infusion, systolic blood pressure fell by 10 +/- 14 mmHg and heart rate increased by 8 +/- 11 bpm. Adverse effects were experienced by 77 people (dizziness in 44; headache in 11; nausea in 9; syncope in 2 and chest pain in 11). Exercise heart rate was 69% +/- 16% of predicted maximum and ST shift was -0.9 +/- 0.9 mm. Following exercise, seven patients required aminophylline (four after dizziness, two after headache, one after chest pain), which was uniformly successful. There were no episodes of prolonged chest pain, MI, death or serious arrhythmia. Safety was maintained for people with severe triple coronary artery disease, the elderly (> 70 yr) and those with significant pulmonary disease. Sensitivity was 95% for at least one with > 70% luminal stenosis and 94% for at least one with > 40% luminal stenosis. Specificity was 28% and 53% respectively. The addition of a symptom-limited exercise test to i.v. dipyridamole is safe for all groups of patients referred for 201Tl study. |
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Authors:
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A P Ignaszewski; L X McCormick; P G Heslip; A J McEwan; D P Humen |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of nuclear medicine : official publication, Society of Nuclear Medicine Volume: 34 ISSN: 0161-5505 ISO Abbreviation: J. Nucl. Med. Publication Date: 1993 Dec |
Date Detail:
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Created Date: 1994-01-07 Completed Date: 1994-01-07 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0217410 Medline TA: J Nucl Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 2053-61 Citation Subset: IM |
Affiliation:
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Department of Medicine, University of Alberta, Edmonton, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Child Child, Preschool Coronary Disease / diagnosis*, radionuclide imaging Dipyridamole / administration & dosage, adverse effects, diagnostic use* Exercise Test* Female Heart Catheterization Hemodynamics / drug effects Humans Infusions, Intravenous Male Middle Aged Sensitivity and Specificity Thallium Radioisotopes / diagnostic use* |
| Chemical | |
Reg. No./Substance:
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0/Thallium Radioisotopes; 58-32-2/Dipyridamole |
| Comments/Corrections | |
Comment In:
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J Nucl Med. 1993 Dec;34(12):2061-3
[PMID:
8254387
]
J Nucl Med. 1994 Dec;35(12):2055 [PMID: 7989993 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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