Picano E, Distante A, Masini M, Morales M A, Lattanzi F, L'Abbate A
Am J Cardiol. 1985 Sep 1;56(7):452-6. doi: 10.1016/0002-9149(85)90884-7.
This study assesses the clinical feasibility and usefulness of dipyridamole infusion for the detection of coronary artery disease (CAD) by using 2-dimensional echocardiography (2-D echo) and 12-lead electrocardiographic monitoring. Dipyridamole infusion (0.14 mg/kg/min for 4 minutes) was performed in 66 consecutive patients with effort chest pain and in 9 control subjects. Among the 28 patients with positive dipyridamole-echocardiography test responses, 18 had diagnostic electrocardiographic changes (ST-segment depression on anterolateral leads), but these changes were unrelated to the site of asynergy. The dipyridamole-echocardiography test had an overall sensitivity of 56% and specificity of 100% for the presence of CAD. Exercise stress testing (EST) had an overall sensitivity of 62% and a specificity of 80%. Thus, the dipyridamole-echocardiography test, which is feasible in essentially all patients with good basal echocardiograms, has a lower overall sensitivity in detecting CAD than EST but a higher specificity, detects the site of apparent ischemia as identified by regional asynergy more precisely than EST, and can unmask electrocardiographically silent effort ischemia.
本研究通过二维超声心动图（2-D 超声）和 12 导联心电图监测，评估双嘧达莫静脉输注用于检测冠状动脉疾病（CAD）的临床可行性和实用性。对 66 例连续性劳力性胸痛患者及 9 例对照受试者进行双嘧达莫静脉输注（0.14mg/kg/min，共 4 分钟）。在双嘧达莫超声心动图试验反应阳性的 28 例患者中，18 例有诊断性心电图改变（前侧壁导联 ST 段压低），但这些改变与运动不协调部位无关。双嘧达莫超声心动图试验对 CAD 存在情况的总体敏感性为 56%，特异性为 100%。运动负荷试验（EST）的总体敏感性为 62%，特异性为 80%。因此，双嘧达莫超声心动图试验在基本上所有基础超声心动图良好的患者中均可行，其检测 CAD 的总体敏感性低于 EST，但特异性更高，比 EST 更精确地检测出由局部运动不协调所确定的明显缺血部位，并且能揭示心电图隐匿性劳力性缺血。
