Early post-infarction angina: usefulness of dipyridamole-echocardiography test.

Abstract

Thirty-nine patients with early post-infarction angina (all with significant, angiographically assessed coronary artery disease and a baseline asynergy on 2-D echo), performed a dipyridamole-echocardiography test (DET: 2-D echo monitoring with dipyridamole infusion, 0.14 mg kg-1 min-1 for 4 min). Twenty-nine patients had a positive DET (sensitivity = 74%). Two mechanical patterns of DET-positivity could be identified: a worsening of the asynergy in that same region showing a baseline asynergy (11 patients); a 'de novo' asynergy in a region remote from the one showing a baseline asynergy (18 patients); The prevalence of single-vessel disease was significantly higher in patients with type 1 positivity pattern (6 single-, three double- and two triple-vessel disease), while patients with type 2 positivity always showed a multivessel coronary involvement (8 double-, 10 triple-vessel disease). In 4 of the 10 patients with 3-vessel disease and type 2 asynergy, such asynergy developed in a territory different from the one supplied by the more stenotic non-infarct-related vessel. In conclusion, DET represents a safe and feasible tool effectively to localize ischaemia, relative to the infarcted region, and to evaluate the haemodynamic significance of coronary lesions in patients with post-infarction angina.