Dipyridamole-echocardiography showed higher feasibility (92% vs 76%, p<0.05) and specificity (92% vs 46%, p<0.05) than exercise-electrocardiography for detecting coronary artery disease.
Cross-Sectional (n=63)
Does the dipyridamole-echocardiography test improve diagnostic accuracy and feasibility compared to the exercise-electrocardiography test for detecting coronary artery disease in essential hypertensive patients with chest pain?
Dipyridamole echocardiography offers significantly higher feasibility and specificity than exercise electrocardiography for the noninvasive detection of coronary artery disease in hypertensive patients with chest pain.
Absolute Event Rate: 92% vs 46%
p-value: p=<0.05
The exercise-electrocardiography test shows limited feasibility and diagnostic accuracy for the noninvasive detection of coronary artery disease in hypertensive patients. Recently, the dipyridamole-echocardiography test (two-dimensional echocardiographic monitoring with dipyridamole infusion, up to 0.84 mg/kg over 10 minutes) has been proposed as an exercise-independent method for the diagnosis of coronary artery disease. The diagnostic usefulness of the exercise-electrocardiography test and the dipyridamole-echocardiography test was evaluated in 63 consecutive inpatients with history of chest pain, essential hypertension, and no previous myocardial infarction. The criterion of positivity for the exercise-electrocardiography test was a horizontal or downsloping ST segment shift exceeding 0.1 mV and for the dipyridamole-echocardiography test, a transient dyssynergy of contraction. Fifteen patients could not perform a diagnostic exercise-electrocardiography test because of an inability to exercise adequately (two patients), severe hypertension in spite of full antihypertensive therapy (six patients), or excessive blood pressure rise at the first step of the exercise-electrocardiography test (seven patients). Five patients could not perform the dipyridamole-echocardiography test because of a poor acoustic window. The overall feasibility was 76% for the exercise-electrocardiography test and 92% for the dipyridamole-echocardiography test (p less than 0.05). All 43 patients who performed both tests underwent coronary angiography; 30 had significant coronary artery disease (greater than 70% lumen reduction of at least 1 major coronary vessel). Sensitivity was 67% for both the exercise-electrocardiography test and the dipyridamole-echocardiography test (p = NS); specificity was 46% for the exercise-electrocardiography test and 92% for the dipyridamole-echocardiography test (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Picano et al. (Thu,) conducted a cross-sectional in Essential hypertension with chest pain (n=63). Dipyridamole-echocardiography test vs. Exercise-electrocardiography test was evaluated on Specificity for detecting significant coronary artery disease (p=<0.05). Dipyridamole-echocardiography showed higher feasibility (92% vs 76%, p<0.05) and specificity (92% vs 46%, p<0.05) than exercise-electrocardiography for detecting coronary artery disease.