Coronary dilation with standard dose dipyridamole and dipyridamole combined with handgrip

James D Rossen; Ignazio Simonetti; Melvin L Marcus; Michael D Winniford

doi:10.1161/01.CIR.79.3.566

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Coronary dilation with standard dose dipyridamole and dipyridamole combined with handgrip

Journal article

Open access

Peer reviewed

Coronary dilation with standard dose dipyridamole and dipyridamole combined with handgrip

James D Rossen, Ignazio Simonetti, Melvin L Marcus and Michael D Winniford

Circulation (New York, N.Y.), Vol.79(3), pp.566-572

03/1989

DOI: 10.1161/01.CIR.79.3.566

PMID: 2917387

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Abstract

Intravenous dipyridamole is widely used to produce coronary vasodilation during cardiac imaging procedures. However, the routinely used dose of dipyridamole (0.56 mg/kg IV over 4 min) does not always result in maximal coronary dilation. The addition of isometric handgrip during dipyridamole coronary dilation has been reported to substantially increase coronary blood flow over dipyridamole alone. We compared the coronary vasodilation resulting from infusion of the standard dose of dipyridamole with that resulting from a maximally dilating dose of intracoronary papaverine in 12 patients with angiographically normal coronary arteries. We also assessed the effect on coronary blood flow velocity of the addition of isometric handgrip during dipyridamole coronary dilation. Changes in coronary blood flow velocity were measured with a 3F coronary Doppler catheter. The coronary flow reserve (peak/resting coronary flow velocity ratio) after dipyridamole (3.7 +/- 1.2 [mean +/- SD] was less than that seen after papaverine (4.4 +/- 0.5, p less than 0.05), and the coronary vascular resistance index during dipyridamole coronary vasodilation (0.28 +/- 0.09) was greater than during papaverine (0.22 +/- 0.03, p less than 0.05). The dipyridamole coronary flow reserve was less than 3.0 in four subjects and was 2.0 or less in two subjects. The addition of isometric handgrip to dipyridamole coronary vasodilation produced an 8% increase in mean heart rate and a 17% increase in mean arterial pressure, but coronary flow reserve was unchanged (3.8 +/- 1.1 before handgrip vs. 4.0 +/- 1.1 with handgrip). Quantitative angiography in six patients revealed no change in coronary caliber with the addition of handgrip.

Angiography

Exercise

Coronary Circulation

Vascular Resistance

Coronary Vessels - physiology

Humans

Middle Aged

Dipyridamole

Male

Coronary Disease - diagnosis

Coronary Angiography

Cardiac Catheterization

Exercise Test

Female

Papaverine

Details

Title: Subtitle: Coronary dilation with standard dose dipyridamole and dipyridamole combined with handgrip
Creators: James D Rossen - Department of Internal Medicine and Cardiovascular Division, University of Iowa, Iowa City 52242
Ignazio Simonetti
Melvin L Marcus
Michael D Winniford
Resource Type: Journal article
Publication Details: Circulation (New York, N.Y.), Vol.79(3), pp.566-572
DOI: 10.1161/01.CIR.79.3.566
PMID: 2917387
NLM abbreviation: Circulation
ISSN: 0009-7322
eISSN: 1524-4539
Publisher: Lippincott Williams & Wilkins; United States
Grant note: HL-07121-12 / NHLBI NIH HHS HL-32295-04 / NHLBI NIH HHS
Language: English
Date published: 03/1989
Academic Unit: Neurology; Cardiovascular Medicine; Neurosurgery; Internal Medicine
Record Identifier: 9984020996802771

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