Prognostic implications of transient left ventricular cavitary dilation during exercise and dipyridamole-thallium imaging.

OBJECTIVE

To determine the prognostic implication of exercise and dipyridamole-induced transient left ventricular cavitary dilation (TLVD).

DESIGN

TLVD was observed and a follow-up obtained in 61 patients after exercise and in 62 patients following dipyridamole infusion.

PATIENTS

There was no statistical difference between groups in terms of sex, history of hypertension, diabetes, renal failure, previous myocardial infarction, severity of angina syndrome, congestive heart failure, resting electrocardiographic (ECG) abnormalities, clinical or ECG signs of ischemia during stress, number of reversible perfusion defects on thallium images or duration of follow-up (21 months).

RESULTS

Dipyridamole patients were slightly older (64 versus 57 years) and displayed more thallium redistribution (P = 0.002). After a mean follow-up of 21 months, both fatal and nonfatal (myocardial infarction or cardiac death) cardiac events were more frequent in the dipyridamole group (50% versus 9%, P = 0.0001).

CONCLUSIONS

Patients with dipyridamole-induced TLVD are at greater risk than those with exercise-induced TLVD at the authors' institution.