ST-segment depression during dipyridamole infusion, and its clinical, scintigraphic and hemodynamic correlates

Am J Cardiol. 1992 Feb 15;69(5):445-8. doi: 10.1016/0002-9149(92)90982-5.


The goal of this study was to determine whether dipyridamole-induced ST-segment depression reflects more severe or extensive myocardial hypoperfusion than the absence of this electrocardiographic finding. The clinical, hemodynamic and scintigraphic correlates of ST-segment depression during intravenous dipyridamole infusion were studied in 204 consecutive patients undergoing dipyridamole stress thallium-201 (Tl-201) imaging for evaluation of coronary artery disease. Of 182 patients with a diagnostic baseline electrocardiogram, 28 (15%) developed ST depression after dipyridamole. Patients with ST depression, compared with those without, were older (64 +/- 1 vs 60 +/- 1 years; p less than 0.03) and had a higher frequency of chest pain (57 vs 23%; p less than 0.001) and a higher heart rate-blood pressure product (12.7 +/- 0.6 vs 11.2 +/- 0.2 x 10(3); p less than 0.008) after dipyridamole. Patients with ST depression were more likely to have Tl-201 redistribution (64 vs 38%; p less than 0.02) and a greater number of redistribution defects (2.3 +/- 0.04 vs 0.9 +/- 0.1, p less than 0.001) than were those without ST depression. By multivariate logistic regression analysis, the most powerful correlate of ST depression was the number of segments having Tl-201 redistribution (p less than 0.001). Other independent correlates were presence of chest pain, heart rate at Tl-201 injection, and age. Thus, the determinants of dipyridamole-induced ST-segment depression include the scintigraphic extent of reversible hypoperfusion, as well as indexes of myocardial oxygen demand.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Analysis of Variance
  • Blood Pressure / drug effects
  • Coronary Disease / diagnostic imaging*
  • Coronary Disease / physiopathology*
  • Dipyridamole*
  • Electrocardiography / drug effects*
  • Female
  • Heart Rate / drug effects
  • Hemodynamics / drug effects*
  • Humans
  • Infusions, Intravenous
  • Logistic Models
  • Male
  • Middle Aged
  • Radionuclide Imaging
  • Thallium Radioisotopes


  • Thallium Radioisotopes
  • Dipyridamole