Usefulness of single-photon emission computed tomography of thallium-201 uptake after dipyridamole infusion for detection of coronary artery disease

Predictors of abnormal heart rate response to dipyridamole in patients undergoing myocardial perfusion SPECT

“…Pharmacologic stress is an alternative for patients unable to exercise or to achieve adequate heart rate during exercise and, due to diagnostic and prognostic values that proved to be comparable to exercise, has gained widespread acceptance [1][2][3][4][5][6].…”

“…Dipyridamole is widely used for pharmacologic stress in myocardial perfusion scintigraphy (MPS) [1][2][3][4][5][6], and for decades has been especially helpful for the evaluation of patients unable to exercise. As a vasodilator, dipyridamole usually causes mild reduction of blood pressure (BP) and increase in heart rate (HR) [7,8], which have been considered as normal hemodynamic responses to this agent.…”

Myocardial perfusion scintigraphy: the evidence

“… No. Tracer Analysis MI excluded Quality Sens (%) Spec (%) Acc (%) Francisco, 1982 [ 32 ] a 75 201 Tl Q No 2 90 96 92 Huikuri, 1988 [ 33 ] a 93 201 Tl V No 2 96 75 94 Go, 1990 [ 34 ] 202 201 Tl V Both b 3 76 80 77 Mendelson, 1992 [ 35 ] a 79 201Tl V Both b 2 90 – – Cramer, 1994 [ 36 ] 38 201 Tl V No 3 90 71 87 Grover-McKay, 1994 [ 21 ] 18 201 Tl V Unknown 1 91 100 94 Ho, 1995 [ 37 ] 54 201 Tl V No 3 98 73 ...…”

“…For pharmacological stress studies using thallium, a number of good quality studies show that sensitivity is in the region of 90% for both dipyridamole [ 21 , 32 , 35 , 36 ] and adenosine [ 46 , 51 ] and that specificity is 75–80% [ 18 , 33 , 34 , 39 , 50 ] although some studies have reported even higher values (95-100%) [ 21 , 32 , 46 ]. Results obtained using MIBI are similar to those obtained using thallium [ 40 , 41 , 43 , 44 , 52 , 53 , 54 ].…”

Direct comparison between pharmacological stress with adenosine triphosphate disodium and exercise stress myocardial perfusion imagings

“…Among these examinations, exercise stress MPI (Ex-MPI) using radioisotope thallium and/or technetium is considered to be one of the most reliable examinations [1,[5][6][7][8][9]. On the other hand, the pharmacological stress MPI with an adenosine receptor agonist is another useful noninvasive method for screening CAD [10][11][12], particularly in elderly or disabled patients who cannot successfully complete the exercise stress test [13]. In addition to dipyridamole or adenosine as pharmacological stress agents, adenosine triphosphate disodium (ATP) has been used for pharmacological stress MPI [14].…”