ABSTRACT
The feasibility, safety and usefulness of dipyridamole echocardiography (two-dimensional echocardiography performed during dipyridamole intravenous infusion, up to 0.84mg/Kg body weight over 10 minutes) were evaluated in 128 patients. Were enrolled in the study: patients with suspicion or clinical diagnosis of coronary artery disease (CAD) with or without previous myocardial infarction. Allpatient underwent selective coronary arteriography 3 weeks before or after dipyridamole echocardiography (DIP-ECHO). Two-dimensional echocardiograms were continously recorded during dipyridamole infusion and up to 20 minutes after the end of the infusion. All standard echocardiographic views (parasternal long and short axis, apical 4--chamber and 2-chamber and apical long-axis viw) were obtained when feasible. Images were recorded in video-tape and analyzed by two observers unaware of clinical and angiographic data. Wall motion was graded as hyperkinetic, normal, hypokinetic, akinetic or dyskinetic. DIP-ECHO was considered positive if transiet new areas of abnormal wall motion or worsening of previous abnormal wall motion (for example, hypokinesia at rest becoming akinesia or dyskinesia after dipyridamole administration) were identified. Any region that was already akynetic or dyskinetic at rest was not considered for analysis. Significant coronary stenosis was defined as 70% reduction in the luminal diameter of the artery. DIP-ECHO had an overall sensitivity of 75%, specificity of 93%, positivie predictive value of 93%, negative predictive value of 65% and accuracy of 80%. Of the 128 patients, side effects occurred in 59% (headache-31%, flushing-10%, arrhythmias-8%, hypertension-4%, nausea -4% and dyspnea -2%). No patient had severe hypotension or significant arrythmias. No side effects were severe and the test was completed in al patients