Dipyridamole-induced angina pectoris during sestamibi stress test in patients with significant coronary artery disease: clinical, angiographic, and nuclear determinants
| Autor: | M. Rosseel, P. Dendale, C. De Sadeleer, D. Schoors, P. Block, P.R. Franken |
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| Rok vydání: | 1997 |
| Předmět: |
Male
Technetium Tc 99m Sestamibi medicine.medical_specialty Vasodilator Agents Myocardial Ischemia Collateral Circulation Coronary Disease 030204 cardiovascular system & hematology Coronary Angiography Angina Pectoris Angina Coronary artery disease 03 medical and health sciences Coronary circulation Electrocardiography 0302 clinical medicine Internal medicine Coronary Circulation medicine ST segment Humans 030212 general & internal medicine Myocardial infarction Prospective Studies Tomography Emission-Computed Single-Photon medicine.diagnostic_test business.industry Heart Dipyridamole Middle Aged medicine.disease medicine.anatomical_structure Logistic Models Coronary steal Cardiology Female Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Angiology. 48(4) |
| ISSN: | 0003-3197 |
| Popis: | Intravenous dipyridamole induces angina pectoris (AP) in some patients with significant coronary artery disease (CAD). The aim of this prospective study was to identify the angiographic, nuclear, and clinical determinants. The authors examined 50 patients consecutively with significant CAD on coronary angiography. All antiischemic medica tions were stopped twenty-four hours (nitrates only 6 hours) before injection of dipyri damole (0.84 mg/kg). ECGs were taken before, during, and after this injection. The regional myocardial activity of Tc-99m-Sestamibi at rest and after dipyridamole injection was measured with single-photon emission computed tomography (SPECT). During dipyridamole injection 20 patients had AP, of whom 15 had ST segment depression on ECG (P < 0.001). The only significant difference on coronary angiography between patients with dipyridamole-induced AP and those without AP was the presence of collaterals (P < 0.05). In patients with AP and collaterals, ECG and SPECT changes were always noted in the collateralized territory. Subgroup analysis showed that patients without previous myocardial infarction (MI, n=17, P < 0.05) or nontransmural MI (n=17, P < 0.05) had a good correlation between collaterals and AP, whereas patients with a history of transmural MI (n=16) did not. No further significant variables could be found as a predictor of AP after dipyridamole injection. These findings suggest that AP during dipyridamole stress test is due to ischemia, which is not related to the severity of CAD. Ischemia is probably due to coronary steal to the collateralized territory in patients without transmural MI. Dipyridamole-induced angina pectoris is predictive for collaterals and may indicate viability in patients with MI. |
| Databáze: | OpenAIRE |
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