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European Heart Journal 1980 1(4):275-280;
Copyright © 1980 by the European Society of Cardiology.
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© 1980 The European Society of Cardiology

Comparison of dipyridamole and treadmill exercise for enhancing thallium-201 perfusion defects in patients with coronary artery disease

A. D. TIMMIS*, J. E. LUTKIN, L. J. FENNEY, S. K. STRAK, R. J. BURWOOD, P. GISHEN and D. A. CHAMBERLAIN

Departments of Cardiology and Nuclear Medicine, Royal Sussex County Hospital Brighton BN2 5BE
Department of Radiology, King's College Hospital Denmark Hill, London SE5 9RS, U.K.

Received 29 April 1980; .

Requests for reprints to: Dr D. A. Chamberlain, Department of Cardiology, Royal Sussex County Hospital, Brighton BN2 5BE, U.K.

Dipyridamole was compared with exercise as a method of enhancing myocardial perfusion defects on thallium-201 scintiscans. Twenty patients with angina had scans after treadmill exercise to near the limit of effort tolerance, and again 4 h later in the redistribution phase. On a separate occasion the same patients had scans after intravenous dipyridamole 0.6 mg/kg. Fifteen of them were also investigated by coronary angiography. Exercise and drug-induced coronary dilatation caused segmental abnormalities of similar degree but the anatomical areas showing these perfusion defects correlated less well. Neither technique offered any clear advantage over the other in predicting the site of coronary stenosis, or in the quality of images obtained. Unwanted drug effects after intravenous dipyridamole were minor but included chest pain in four patients. Intravenous dipyridamole can reasonably be used instead of exercise for thallium-201 scintiscans. The technique will be of particular value when exercise testing is impracticable.

Key Words: Thallium-201 • scintiscans • dipyridamole • coronary artery disease • stress testing


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