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Diagnosis of Ischemic Heart Disease by Dipyridamole Stress Echocardiography:Evaluation of the diagnostic criterion including fixed wall motion Yutaka Hirano 1 , Tadahiko Yamamoto 1 , Takeshi Sasaki 1 , Takeo Naito 1 , Hiroshi Ikawa 1 , Hirofumi Habu 1 , Yasuyuki Okabayashi 1 , Eiichi Enya 1 , Toshio Miyazaki 1 , Kinji Ishikawa 1 , Ryo Katori 1 1The First Department of Internal Medicine, Kinki University School of Medicine Keyword: 虚血性心疾患 , ジピリダモール , 超音波断層法 , dipyridamole , echocardiography , ischemic heart disease pp.681-686
Published Date 1995/7/15
DOI https://doi.org/10.11477/mf.1404901083
  • Abstract
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Dipyridarnole stress echocardiography test (DSET) has been a potential alternative to exercise ECG for diagnosing coronary artery disease. However, whether lack of hyperdynamic response to DSET could be a marker of myocardial ischemia comparable with new wall motion abnormalities remains uncertain. To address this question, we compared a combination offixed and worsening wall motion by DSET with worsen-ing wall motion alone as criteria for diagnosing coro-nary artery stenosis (%stenosis greater than 75%). DSET, 0.84 mg/min over 10 min, was performed in 45 patients with suspected coronary artery disease, and echo images were evaluated semiquantitatively using digital quad-screen format. A fixed wall motion was defined as no worsening or improvement in wall motion from baseline echocardiogram. Coronary angiographv and exercise thallium-201 scintigraphy were carried out in all patients. When the worsening wall motion in-duced by dipyridamole was considered positive for coronary artery disease, the sensitivity, specificity and diagnostic accuracy of the DSET were 61% (17/28). 100% (17/17) and 80% (34/45). respectively. When both the worsening and fixed wall motion were consid-ered positive, the sensitivity, specificity and diagnostic accuracy were 86% (24/28), 94% (16/17) and 89% (40/ 45), respectively. The sensitivity, specificity and diag-nostic accuracy for exercise thallium-201 scintigraphy were 89% (25/28), 71% (12/17), 82% (37/45), respec-tively. Side effects were observed in 53% (24/45) of patients, but were all mild and transient.

In conclusion, under the diagnostic criterion including fixed wall motion, DSET demonstrated a similar sensi-tivity and specificity for detection of coronary artery stenosis compared with exercise thallium-201 scintigra-phy.


Copyright © 1995, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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