Search

Low (0·56 mg.kg−1 over 4 min) and high (0·48 mg.kg−1 over 10 min) doses of dipyridamole can identify viable myocardium through the contractile recovery of basally dyssynergic regions; however, it also induces ischaemia in susceptible patients. The aim of this study was to assess the potential of an ‘infra-low’ dose of dipyridamole to selectively identify myocardial viability, independently evaluated by low dose dobutamine. Forty patients with resting dyssynergy and angiographically assessed coronary artery disease (1-vessel in 18, 2-vessel in 12, and 3-vessel in 10 patients) separately underwent a low dose dobutamine (5–10μg. kg−1 min for 3 min) echo test and an infra low dose (0·28 mg.kg−1 over 4 min) dipyridamole echo test. Systolic blood pressure (rest: 131±19 mmHg) changed slightly after dobutamine (137±21, P<0·05 vs rest) and remained stable after dipyridamole (130± 17, p=ns vs rest). Heart rate (rest: 68±13 beats. min−1) was also unchanged after dipyridamole (69±12, P=ns vs rest) and increased slightly after dobutamine (71±15, P<0·05 vs rest and vs dipyridamole). No patient developed echocar diographic or electrocardiographic signs of ischaemia after either dipyridamole or dobutamine. Of the 243 segments with baseline dyssynergy, 70 were responders (i.e. they showed an improvement of I grade or more, from I normalIhyperkinetic to 4=dyskinetic in a 16-segment model of the left ventricle) by both dipyndamole and dobutamine, 157 were non-responders (i.e. they showed no change) by both dipyridamole and dobutamine, and 16 showed discordant results (five responders by dipyridamole only; 11 by dobutamine only). The overall concordance of dipyridamole and dobutamine was 93%. An echocardio graphic follow-up could be obtained >6 weeks after suc cessful revascularization (achieved with angioplasty in 17, with by pass surgery in 3) in 19 patients and showed an improvement of one grade or more in 50 segments (viable) and no improvement in 50 segments (necrotic). The sensi tivity of dobutamine and dipyridamole for predicting recov ery was 76 and 78% respectively (p=ns); the specificity of both tests was 94%.In conclusion, infra-low dose dipyridamole is a haemody namically neutral stress test which does not affect either heart rate or systolic blood pressure; it allows myocardial viability to be explored selectively, without eliciting ischae mia; it shows excellent overall concordance with low dose dobutamine and has good sensitivity and excellent specifi city for predicting functional recovery following successful revascularization. [ABSTRACT FROM PUBLISHER]

An abstract of the article "Comparison of transthoracic Doppler echocardiography to intracoronary Doppler guide wire measurments for assessment of coronary flow velocity reserve in patients with previous myocardial infarction," by A. Djordjevic-Dikic and colleagues is presented.

An abstract of the article "Noninvasive assessment of coronary flow reserve after elective stenting in patients with previous myocardial infarction: Relation to left ventricular recovery," by B. Beleslin and colleagues is presented.

An abstract of the article "Can we predict acute coronary events by myocardial jeopardy score in patients with natural progression of coronary artery disease,' by I. Nedeljkovic and colleagues is presented.

An abstract of the article "Cultural Evolution of Digital Description of Coronary Artery Disease Severity Potential of Inducing Myocardial Ischemia During Exercise Stress Echocardiography" by I.P. Nedeljkovic and colleagues is presented.

An abstract of the article "Mental Stress and Myocardial Ischemia: Hemodynamic and Echocardiographic Parameters" by J. Stepanovic and colleagues is presented.

An abstract of the article "Influence of Beta-Blockade on Results of Low-Dose Dipyridamole Echocardiography Tests for Myocardial Viability" by A. Djordjevic-Dikic and colleagues is presented.

An abstract of the article "Functional mitral regurgitation in patients with prior myocardial infarction - Quantitative exercise-echocardiographic study" by V. Giga and colleagues is presented.

An abstract of the article "Prediction of mortality by modified myocardial jeopardy score: a strategy for combination with stress echocardiography," by I.P. Nedeljkovic and colleagues is presented.