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In 45 patients with coronary artery disease, proven by coronary arteriography, and 15 patients without such disease 0.5 mg dipyridamole (Persantin) per kg body weight was injected i.v. over ten minutes. In 40 of the 45 patients with coronary artery disease anginal pain occurred during or immediately after dipyridamole injection and ceased immediately after intravenous administration of 0.24 g aminophylline (positive test), while in three it had stopped spontaneously without aminophylline (questionable positive test). Only in two of the 45 patients with confirmed coronary artery disease was there no anginal pain (false-negative result). None of the 15 patients without coronary artery disease had anginal pain during the test. It is concluded from these results that the "dipyridamole test", which is simple to perform and does not stress the patient significantly, is at least equivalent diagnostically to the exercise E.C.G. test.

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Gated magnetic resonance imaging of the heart displays cardiac structures with excellent resolution. This ability should be useful for assessment of cardiac physiology where acquisition of systolic and diastolic images is required. In this study, left ventricular ejection fraction was determined in 50 patients from oblique long axis views of the left ventricle using the area length formula. Angulated views were obtained by electronic gradient angulation. For comparison, all patients had monoplane angiocardiography in the RAO position. Forty-five patients were also studied by radionuclide ventriculography. Ejection fractions determined by MRI and angiocardiography were closely correlated (r = 0.90). Correlation between MRI and radionuclide ventriculography was also acceptable (r = 0.79). In addition to global left ventricular function, MR images provide information about regional wall motion. In order to acquire a three-dimensional set of images at various phases of the cardiac cycle, shorter imaging times are mandatory. A new imaging technique with potential for functional studies uses low flip angles, short repetition times and gradient refocused echoes. Up to 40 images can be obtained within one cardiac cycle. When displayed in a looped fashion, visual assessment of cardiac motion, intracardiac blood flow, and systolic wall thickening is possible. Potential advantages of functional studies by MRI are the concomitant acquisition of anatomical information and the three dimensional frame of reference.