[Exercise and dipyridamole-loading in evaluation of ischemic coronary lesion and coronary reserve in children with Kawasaki disease].

In order to compare the clinical effects of exercise-loading and intravenous dipyridamole-loading tests in evaluating ischemic coronary lesion and coronary reserve, we evaluated changes in ECG, 201-Tl scintigraphy, coronary flow and myocardial metabolism in 10 patients with Kawasaki disease (age range: 7-16 years). Although both loading tests affect coronary hemodynamics and myocardial metabolism by different mechanisms, both were equally effective in detecting ischemic coronary lesion and reduced coronary reserve. On the other hand, when considered on the basis of clinical examination methods used, the dipyridamole-loading test was more effective for evaluating clinical symptoms and ECG, while exercise-loading was more effective for evaluating 201Tl scintigraphy and supply-demand balance. These results suggest that, in the evaluation of ischemic coronary lesion, assessment of clinical effects by a combination of several examination methods is required.