High Dose Dipyridamole-Echocardiography Test in Women: Correlation With Exercise-Electrocardiography Test and Coronary Arteriography

• Published in: Journal of the American College of Cardiology 1988-09, Vol.12 (3), p.682-685
• Main Authors: Masini, Michele, Picano, Eugenio, Lattanzi, Fabio, Distante, Alessandro, L'Abbate, Antonio
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Cardiology. Vascular system; Coronary Angiography; Coronary Disease - diagnosis; Coronary Disease - physiopathology; Coronary heart disease; Dipyridamole; Echocardiography - methods; Electrocardiography; Exercise Test; Female; Heart; Humans; Medical sciences; Middle Aged; Sex Factors
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/S0735-1097(88)80056-1

The value of the exercise-electrocardiography test in detecting coronary artery disease in women is limited. Recently, the high dose dipyridamole-echocardiography test (two-dimensional echocardiographic monitoring during intravenous dipyridamole infusion, up to 0.84 mg/kg body weight over 10 min) was proposed as an alternative to exercise testing for the diagnosis of coronary artery disease. To establish the diagnostic usefulness of the exercise-electrocardiography and dipyridamole-echocardiography tests in this disease, the two tests were performed-on different days and in random order-in 83 consecutive women evaluated for a chest pain syndrome. All 83 women had taken no medications for >48h, and 15 had had a previous myocardial infarction. Positivity of the dipyridamole-echocardiography test was based on detection of a transient asynergy of contraction that was absent or of lesser degree at rest; the exercise-electrocardiography test (by upright cycloergometer) was considered positive when the ST segment was shifted >0.1 mV 0.08 s after the J point. Coronary angiography showed significant coronary artery disease (>70% luminal reduction of at least one major coronary vessel) in 39 women. No significant complications occurred in any patient during either test. Sensitivity and predictive value of a negative test were similar for the dipyridamole-echocardiography and the exercise-electrocardiography test (79 versus 72% and 84 versus 68%, respectively, whereas the dipyridamoleechocardiography test had greater specificity (93 versus 52%, p < 0.001), accuracy (87 versus 62%, p < 0.001) and a higher predictive value of a positive test (91 versus 57%, p < 0.01). Thus, the dipyridamole-echocardiography test appears to be of greater diagnostic value than does the exerciseelectrocardiography test for noninvasive detection of coronary artery disease in women.