Key result
Three-vessel slow coronary flow linked to ischemic-like dipyridamole perfusion responses unlike single-vessel involvement.
Why the study?
Does dipyridamole stress testing reveal different myocardial perfusion patterns in acute patients with single-vessel versus three-vessel slow coronary flow?
Observational (n=28)
Does dipyridamole stress testing reveal different myocardial perfusion patterns in acute patients with single-vessel versus three-vessel slow coronary flow?
Absolute Event Rate: 15% vs 37.8%
Dipyridamole stress testing reveals a normal perfusion response in patients with single-vessel slow coronary flow, but an ischemic-like response in those with three-vessel involvement.
Three-vessel slow flow was associated with ischemic-like dipyridamole perfusion unlike single-vessel; hypothesis-generating and should not yet change practice.
OBJECTIVE: We investigated myocardial perfusion in acute patients with slow coronary flow (SCF) at angiography. Whether impaired myocardial perfusion occurs in acute patients with SCF is unknown. METHODS: We enrolled 28 consecutive patients with SCF in the epicardial coronary arteries with no evidence of significant stenosis. SCF affected a single coronary artery in 14 patients (group A) and all three coronary vessels in 14 others (group B). Coronary angiography was repeated after dipyridamole infusion and single photon emission computed tomography was performed using dipyridamole as the stress agent. The Thrombolysis in Myocardial Infarction frame count was measured in SCF vessels at baseline and after dipyridamole infusion. RESULTS: Mean Thrombolysis in Myocardial Infarction frame count significantly decreased after dipyridamole in both groups. At baseline, mean values of the single photon emission computed tomography score were 31.5 +/- 1.6 and 25.1 +/- 2.1 in groups A and B, respectively. After dipyridamole, they increased from 31.5 +/- 1.6 to 37.8 +/- 1.4 (P < 0.001) in group A, whereas a further decrease to 15.0 +/- 1.2 (P < 0.005) was observed in group B. CONCLUSIONS: An opposite behavior of myocardial perfusion was observed after dipyridamole infusion: a normal response in patients with SCF affecting one single coronary artery versus an ischemic-like response in those with CSF affecting all three coronary arteries.
No takes yet. Share an insight, caveat, or question.
Mangieri et al. (2006) conducted an observational in Slow coronary flow (n=28). Slow coronary flow affecting all three coronary vessels vs. Slow coronary flow affecting a single coronary artery was evaluated on Single photon emission computed tomography score after dipyridamole. Slow coronary flow affecting all three vessels showed an ischemic-like perfusion response to dipyridamole (SPECT score 15.0), whereas single-vessel involvement showed a normal response (score 37.8).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: