平野 豊, 山本 忠彦, 上原 久和, 小笹 義尚, 山田 覚, 井川 寛, 石川 欽司

Yutaka HIRANO, Tadahiko YAMAMOTO, Hisakazu UEHARA, Yoshihisa OZASA, Satoru YAMADA, Hiroshi IKAWA, Kinji ISHIKAWA

近畿大学医学部第1内科学教室

First Department of Internal Medicine, Kinki University School of Medicine, 377-2 Ono-higashi, Osaka-Sayama-shi, Osaka-fu 589-8511, Japan

キーワード : Coronary artery disease, Dipyridamole, Exercise, Stress echocardiography

The diagnostic usefulness of dipyridamole-exercise stress echocardiography in detecting coronary artery diseases was evaluated in 34 consecutive patients, 18 of single-vessel disease, 4 of double-vessel disease and 1 of triple-vessel disease. Two dimensional echocardiographic images were digitized and assigned in a quad-screen format for nonbiased interpretation. Dipyridamole was administered intravenously as follows: 0.56 mg⁄kg over a period of 4 minutes, no medication for the next 4 minutes, and then 0.28 mg⁄kg over 2 minutes. Exercise was then performed at 50 watts for 3 minutes in the 20 to 30 degree left decubitus position on an echo-bed with an ergometer 5 minutes after the dipyridamole infusion. Intravenous aminophylline was administered at a dose of 125 mg over a period of 1 minute when patients complained of chest pain and showed ST depression of more than 0.2 mV at 80 msec from the J point or showed wall motion abnormalities. All patients underwent coronary angiography. Significant coronary artery disease was defined as ≥75% stenosis of the large coronary arteries. Sensitivity of dipyridamole echocardiography versus dipyridamole-exercise echocardiography was 57% versus 87% (p