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 stress echocardiography, Doppler echocardiography, Ischemia

To investigate the clinical significance of flow propagation velocity (FPV) in color M-mode Doppler echocardiography during the dipyridamole echocardiography test, we determined wall motion abnormalities and FPV, both at the baseline and after high-dose dipyridamole infusion, in 9 control subjects (group N) and 17 patients with ischemic heart disease (group I). Dipyridamole was administered intravenously at a dose of 0.56 mg/kg over 4 minutes, followed by 4 minutes with no dose, and then at a dose of 0.28 mg/kg over 2 minutes. Two-dimensional echocardiographic images were digitized and assigned in a quad-screen format for nonbiased interpretation. FPV ratio was denned as the ratio of the value at high-dose dipyridamole infusion to that at the baseline. All patients underwent coronary angiography. Significant coronary artery disease was defined as≥75% stenosis of the large coronary arteries. Wall motion abnormalities worsened or new ones developed during dipyridamole infusion in 10 patients in group I, compared with none in group N. FPV increased significantly in group N but did not increase in group I. FPV ratio was significantly lower in group I than in group N (P