Document Detail

The clinical and pathophysiologic implications of pain, ST abnormalities, and scintigraphic changes induced during dipyridamole infusion: their relationships to the peripheral hemodynamic response.
MedLine Citation:
PMID:  3177178     Owner:  NLM     Status:  MEDLINE    
In order to determine their significance during dipyridamole perfusion scintigraphy, symptomatic, ECG, and scintigraphic findings were related to each other, to the hemodynamic response, and to angiographic findings in 73 consecutive patients having coronary angiography within 3 months of scintigraphy. The group having induced "cardiac" pain differed from the group without induced pain only in their higher incidence of induced ischemic ST changes, the "marked" hemodynamic response, and their lower incidence of an "absent" hemodynamic response (all p less than 0.01). Induced ST depression was found only in patients with coronary disease. In this population, dipyridamole-induced pain was a moderately specific marker and induced ST abnormalities a more highly specific marker for coronary disease. However, both were insensitive for coronary disease diagnosis. If induced pain or ST abnormalities in the presence of significant coronary disease were accepted as indicators of ischemia, then scintigraphic abnormalities appeared to be produced by dipyridamole in roughly equal incidence by ischemic and nonischemic mechanisms. Induced ischemia related frequently to an exaggerated hypotensive response with no change in double product, suggesting its cause to be an induced increase in myocardial oxygen demand. Dipyridamole-induced image defects were noted even in the absence of a peripheral hemodynamic response. This indicates that the peripheral response does not always correlate with its central coronary effect and an absent peripheral hemodynamic response does not necessarily invalidate scintigraphic results.
Y Y Zhu; W Lee; E Botvinick; M Dae; K Chatterjee; J Danforth; T Ports
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  116     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1988 Oct 
Date Detail:
Created Date:  1988-11-07     Completed Date:  1988-11-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1071-80     Citation Subset:  AIM; IM    
Department of Medicine, University of California, San Francisco 94143.
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MeSH Terms
Angina Pectoris / chemically induced*
Chest Pain / chemically induced
Coronary Angiography
Coronary Disease / diagnosis,  radionuclide imaging*
Dipyridamole / diagnostic use*
Exercise Test
Heart / radionuclide imaging*
Hemodynamics / drug effects*
Middle Aged
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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