Safety, feasibility, and diagnostic accuracy of accelerated high-dose dipyridamole stress echocardiography

被引:40
作者
Dal Porto, R
Faletra, F
Picano, E
Pirelli, S
Moreo, A
Varga, A
机构
[1] CNR, Inst Clin Physiol, I-56123 Pisa, Italy
[2] Niguarda Hosp, Milan, Italy
关键词
D O I
10.1016/S0002-9149(00)01424-7
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Protocols for dipyridamole stress testing have evolved in the last 16 years in the neverending quest of optimal diagnostic accuracy and user friendliness. Higher dipyridamole dose in a shorter infusion time provides higher sensitivity, but concern over safety is still controversial. An accelerated high-dose (0.84 mg/kg in 6 minutes without atropine) dipyridamole stress test was performed on 1,295 patients in 2 echocardiographic laboratories: institute of Clinical Physiology of Pisa and Niguarda Hospital of Milan. During testing, there were no deaths and no patients had ventricular fibrillation. Major adverse reactions occurred in 3 cases (1 every 431 studies): 1 myocardial infarction, 1 brief cardiac asystole, and 1 transient ischemic attack. Overall feasibility was 97%. In 66 patients with normal function at rest who were evaluated off therapy, with coronary angiography performed independently of test results, the accelerated high-dose protocol showed a sensitivity of 85% (confidence interval [CI] 73% to 92%) and a specificity of 93% (CI 83% to 97%) for angiographically assessed coronary artery disease (quantitatively assessed diameter reduction greater than or equal to 50%). Diagnostic accuracy of the accelerated high dose was 89% (CI 79% to 95%). Thus, accelerated high-dose dipyridamole stress echocardiography was reasonably safe and well tolerated. This protocol is especially appealing for its excellent diagnostic accuracy coupled with the short imaging time and no need for drug cocktails. (C) 2001 by Excerpta Medica, Inc.
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收藏
页码:520 / 524
页数:5
相关论文
共 22 条
  • [1] Stress echocardiography: Recommendations for performance and interpretation of stress echocardiography
    Armstrong, WF
    Pellikka, PA
    Ryan, T
    Crouse, L
    Zoghbi, WA
    [J]. JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 1998, 11 (01) : 97 - 104
  • [2] Cheitlin MD, 1997, CIRCULATION, V95, P1686
  • [3] Dobutamine stress echocardiography - Safety in diagnosing coronary artery disease
    Lattanzi, F
    Picano, E
    Adamo, E
    Varga, A
    [J]. DRUG SAFETY, 2000, 22 (04) : 251 - 262
  • [4] SAFETY OF DIPYRIDAMOLE TESTING IN 73,806 PATIENTS - THE MULTICENTER DIPYRIDAMOLE SAFETY STUDY
    LETTE, J
    TATUM, JL
    FRASER, S
    MILLER, DD
    WATERS, DD
    HELLER, G
    STANTON, EB
    BOM, HS
    LEPPO, J
    NATTEL, S
    [J]. JOURNAL OF NUCLEAR CARDIOLOGY, 1995, 2 (01) : 3 - 17
  • [5] Lowenstein J., 1998, European Heart Journal, V19, P608
  • [6] MARWICK T, 1997, TXB CARDIOVASCULAR M, P1267
  • [7] DIPYRIDAMOLE-ECHOCARDIOGRAPHY TEST IN EFFORT ANGINA-PECTORIS
    PICANO, E
    DISTANTE, A
    MASINI, M
    MORALES, MA
    LATTANZI, F
    LABBATE, A
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1985, 56 (07) : 452 - 456
  • [8] The comparable diagnostic accuracies of dobutamine-stress and dipyridamole-stress echocardiographies: a meta-analysis
    Picano, E
    Bedetti, G
    Varga, A
    Cseh, E
    [J]. CORONARY ARTERY DISEASE, 2000, 11 (02) : 151 - 159
  • [9] SAFETY OF INTRAVENOUS HIGH-DOSE DIPYRIDAMOLE ECHOCARDIOGRAPHY
    PICANO, E
    MARINI, C
    PIRELLI, S
    MAFFEI, S
    BOLOGNESE, L
    CHIRIATTI, G
    CHIARELLA, F
    ORLANDINI, A
    SEVESO, G
    COLOSSO, MQ
    SCLAVO, MG
    MAGAIA, O
    AGATI, L
    PREVITALI, M
    LOWENSTEIN, J
    TORRE, F
    ROSSELLI, P
    CIUTI, M
    OSTOJIC, M
    GANDOLFO, N
    MARGARIA, F
    GIANNUZZI, P
    DIBELLO, V
    LOMBARDI, M
    GIGLI, G
    FERRARA, N
    SANTORO, F
    LUSA, AM
    CHIARANDA, G
    PAPAGNA, D
    COLETTA, C
    BOCCARDI, L
    DECRISTOFARO, M
    PAPI, L
    LANDI, P
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1992, 70 (02) : 252 - 258
  • [10] ENHANCED SENSITIVITY FOR DETECTION OF CORONARY-ARTERY DISEASE BY ADDITION OF ATROPINE TO DIPYRIDAMOLE-ECHOCARDIOGRAPHY
    PICANO, E
    PINGITORE, A
    CONTI, U
    KOZAKOVA, M
    BOEM, A
    CABANI, E
    CIUTI, M
    DISTANTE, A
    LABBATE, A
    [J]. EUROPEAN HEART JOURNAL, 1993, 14 (09) : 1216 - 1222