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Effect of chronic sustained-release dipyridamole on myocardial blood flow and left ventricular function in patients

Mateen Akhtar1, Karen Ordovas, Alastair Martin

  • 1Department of Medicine, Division of Cardiology, University of California at San Francisco, San Francisco, CA, USA.

Congestive Heart Failure (Greenwich, Conn.)
|June 2, 2007
PubMed

Insights

Sustained-release dipyridamole/aspirin significantly improved coronary blood flow and left ventricular systolic function in patients with ischemic cardiomyopathy. This pilot study shows potential for treating heart failure and enhancing myocardial perfusion.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Coronary ischemia can lead to ischemic cardiomyopathy, impairing left ventricular function.
  • Dipyridamole is known to increase adenosine levels and improve coronary collateralization.

Purpose of the Study:

  • To evaluate the effect of sustained-release dipyridamole/aspirin on coronary flow reserve and left ventricular systolic function.
  • To assess changes in myocardial perfusion and function in patients with ischemic cardiomyopathy.

Main Methods:

  • A pilot study involving six outpatients with coronary artery disease and LVEF <40%.
  • Treatment with sustained-release dipyridamole 200 mg/aspirin 25 mg twice daily for 6 months.
  • Assessment using MRI stress perfusion studies at baseline, 3, and 6 months, measuring coronary sinus flow and myocardial perfusion.

Main Results:

  • Left ventricular ejection fraction (LVEF) increased significantly (39%+/-64%, P=.01).
  • Hyperemic coronary sinus flow more than doubled (P=.01).
  • Stress-induced relative myocardial perfusion increased by 35%+/-13% (P=.004).

Conclusions:

  • Sustained-release dipyridamole/aspirin effectively improved hyperemic myocardial blood flow.
  • The treatment enhanced left ventricular systolic function in patients with ischemic cardiomyopathy.
  • No significant changes were observed in heart failure or angina class.

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