Dipyridamole-induced ST segment depression during thallium-201 imaging in patients with coronary artery disease: angiographic and hemodynamic determinants

Journal Article · Fri Jul 01 00:00:00 EDT 1988 · J. Am. Coll. Cardiol.; (United States)

DOI:https://doi.org/10.1016/0735-1097(88)90353-1· OSTI ID:7140447

Chambers, C E; Brown, K A

To examine the angiographic and hemodynamic determinants of dipyridamole-induced ST segment depression in patients with coronary artery disease, 41 patients with angiographically documented coronary disease who underwent dipyridamole-thallium-201 myocardial scintigraphy were studied. Dipyridamole-induced ST depression occurred in 14 (34%) of the 41 patients. Stepwise multivariate logistic regression was performed to compare the predictive value of angiographic findings (good coronary collateral vessels, jeopardized collateral vessels, multivessel disease), hemodynamic changes (changes in heart rate, systolic pressure, diastolic pressure and rate-pressure product), thallium-201 results (perfusion defect, thallium-201 redistribution) and demographic data (age, gender, medications). Only the presence of good coronary collateral vessels (p less than 0.02) and increases in rate-pressure product after dipyridamole infusion (p less than 0.02) were significant multivariate predictors of dipyridamole-induced ST depression. Good collateral vessels were more common in the group with ST depression (11 (79%) of 14) than they were in the group without ST depression (6 (22%) of 27; p less than 0.001). Rate-pressure product increased 2,835 +/- 1,648 beats/min.mm Hg in the group with ST depression compared with 1,179 +/- 1,417 beats/min.mm Hg in patients without ST depression (p less than 0.005). In conclusion, dipyridamole-induced ST segment depression in patients with coronary artery disease appears to be related to 1) the presence of good coronary collateral vessels, which may act by facilitating coronary steal, and 2) increases in rate-pressure product, reflecting increased myocardial oxygen demand. These observations may explain the lack of prognostic value of dipyridamole-induced ST segment depression described in previous reports.

• Research Organization: Univ. of Vermont, Burlington (USA)
• OSTI ID: 7140447
• Journal Information: J. Am. Coll. Cardiol.; (United States), Journal Name: J. Am. Coll. Cardiol.; (United States) Vol. 12:1; ISSN JACCD
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR AGENTS
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
DRUGS
ELECTRON CAPTURE RADIOISOTOPES
ELECTROPHYSIOLOGY
HEART
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MUSCLES
MYOCARDIUM
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
PHYSIOLOGY
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
THALLIUM 201
THALLIUM ISOTOPES
VASODILATORS