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European Heart Journal 1997 18(Supplement D):16-23; doi:10.1093/eurheartj/18.suppl_D.16
Copyright © 1997 by the European Society of Cardiology.
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© 1997 The European Society of Cardiology

Dipyridamole stress echocardiography:State of the art 1996

E. Picano, M. Ostojic, R. Sicari, M. Baroni, L. Cortigiani, A. Pingitore on behalf of the EPIC (Echo Persantin International Cooperative) study group

CNR, Institute of Clinical Physiology Pisa, Italy

Correspondence: Eugenio Picano, MD, PhD, FESC, CNR. Institute of Clinical Physiology. Via Savi 8, 56100, Pisa, Italy

Dipyridamole stress is the forerunner and prototype of pharmacological stress echo tests in the diagnosis of coronary artery disease. Among the various stress echo tests, it is probably the least technically demanding to perform and the easiest to interpret. Its accuracy is similar to dobutamine stress echocardiography but its feasibility is higher. The prognostic impact of dipyridamole stress echo has also been proven for presentation of hard end-points such as cardiac death. The safety and prognostic value of this test has been conclusively demonstrated as a result of extensive experience in large scale multicentre projects.

Dipyridamole stress is many different tests in one: dipyridamole—atropine is best for diagnosis; dipyridamole—dobutamine or dipyridamole—exercise is highly sensitive for the detection of minor forms of coronary artery disease; low and high dose dipyridamole is best suited for prognostic stratification; infra-low dipyridamole with low dose dobutamine administration is probably best suited for selective myocardial viability identification. Each patient should have their own test, tailored on the basis of the clinical picture and the diagnostic issue.

Key Words: Dipyridamole • ischaemia • prognosis • viability • ultrasound


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