DIPYRIDAMOLE ELECTROCARDIOGRAPHY TEST FOR THE ASSESSMENT OF THE SEVERITY OF CORONARY ARTERY DISEASE
スポンサーリンク
概要
- 論文の詳細を見る
The purpose of this study was to investigate the relationship of dipyridamole-induced ST changes to the severity of coronary artery disease. The subjects were 100 patients without myocardial infarction who underwent coronary arteriography for the diagnosis of coronary artery disease. The dipyridarnole injection test (D) (0.568 mg/kg/4 min), and symptom-limited treadmill exercise test (T) were performed separately. Body surface electrocardiographic mapping of 87 leads was performed in both tests. The incidences of significant ST depression ≤ 0.10 mV, number of leads showing significant ST depression (nST) and the maximal voltage of ST depression (maxST) in D and T were compared to the number of diseased coronary arteries. In patients without significant coronary stenosis (0VD group), the incidence of ST depression in the dipyridamole test was significantly lower than that in the treadmill test (D 9% vs T 47%, p<0.01). While, in one vessel disease (1VD), two vessel disease (2VD), and three vessel disease (3VD)groups, there was no significant difference in the incidence of ST depression between the dipyridamole test and the treadmill test (in 1VD, D 44% vs. T 65%; in 2VD, D 67% vs. T 93%; and in 3VD D 93% vs. T , 96%). In the dipyridamole test, nST was 0.6±2.4 in 0VD, 4.5±6.9 in 1VD, 4.1±4.5 in 2VD, and 10.6±8.1 in 3VD. Significant differences were found between 0VD and 1VD (P<0.05), 0VD and 3VD (P<0.01). 1VD and 3VD (P<0.01), and 2VD and 3VD (p<0.01). The maxST in the dipyridamole test was 0.02±0.04 mV in 0VD, 0.10±0.12 mV in 1VD. 0.13±0.11 mV in 2VD, and 0.22±0.11 mV in 3VD. Significant differences were found between 0VD and 1VD (p<0.01), 0VD and 2VD (p<0.01), 0VD and 3VD (p<0.01), 1VD and 3VD (p<0.01), and 2VD and 3VD (P<0.01). For the diagnosis of 3VD, the dipyridamole ECG test had as high a sensitivity (93% vs 96%), higher specificity (68% vs 38%, p<0.01), and higher predictive accuracy (75% vs 54%, p<0.01) than the treadmill test. For the detection of one or more stenotic coronary arteries, the dipyridamole test had a lower sensitivity (70% vs 85%, p<0.05), but higher specificity (91% vs 53%, p< 0.01), and as high a predictive accuracy (77% vs 74%) compared with the treadmill test. This study demonstrated that the dipyridamole ECG test was useful in stratifying the severity of coronary artery disease. Dipyridamole ECG was both sensitive and specific for the detection of 3VD.
- 社団法人日本循環器学会の論文
- 1992-03-20
著者
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Yamaguchi Seiji
Internal Medicine Sagae Hospital
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Tomoike Hitonobu
National Cardiovascular Center
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Yamaki Michiyasu
Takaha Public Hospital
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Yamaki Michiyasu
Disivion Of Medical Informatics Yamagata University School Of Medicine
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Kubota Isao
山形大学 医学部循環･呼吸･腎臓内科学
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Kubota Isao
the First Department of Internal Medicine, Yamagata University School of Medicine
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YAMAKI Michiyasu
The First Dep. of Internal Medicine, Yamagata University School of Medicine
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TOMOIKE Hitonobu
The First Dep. of Internal Medicine, Yamagata University School of Medicine
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Ikeda Kozue
The First Department of Internal Medicine, Yamagata University School of Medicine
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KATO NAOMI
The First Department of Internal Medicine, Yamagata University School of Medicine, Yamagata
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HOSOYA YUKIO
The First Department of Internal Medicine, Yamagata University School of Medicine, Yamagata
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YASUI SHOJI
Nagoya National Hospital
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Tomoike Hitonobu
The First Department Of Internal Medicine Yamagata University School Of Medicine
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Yamauchi Sou
The First Department Of Internal Medicine Yamagata University School Of Medicine
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Kiriyama Naomi
The First Department Of Internal Medicine Yamagata University School Of Medicine Yamagata
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Yasui S
The Department Of Public Health
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Ikeda Kozue
The First Department Of Internal Medicine Yamagata University School Of Medicine
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Yamaguchi Seiji
The First Department Of Internal Medicine Yamagata University School Of Medicine
-
Tomoike Hitonobu
First Department Of Internal Medicine Yamagata University School Of Medicine
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Kubota Isao
The Fiest Department Of Internal Medicene Yamagata University School Of Medicine
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Ikeda Kozue
The 1st Dept. Of Int. Med. Yamagata Univ. School Of Med.
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Ikeda Kozue
The First Department Of Internal Medicine And Clinical Laboratory Yamagata University School Of Medi
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Kubota Isao
Department Of Cardiology Pulmonology And Nephrology Yamagata University Of School Of Medicine
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Yamauchi Sou
Sagae City Hospital
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KATO Naomi
The First Department of Internal Medicine, Yamagata University School of Medicine
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HOSOYA Yukio
The First Department of Internal Medicine, Yamagata University School of Medicine
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