Comparative value of effort and adenosine-testing in the evaluation of patients with old myocardial infarction

Exercise testing (ET) and adenosine testing (AT) coupled with ECG were applied in 25 patients with old myocardial infarction. ET was positive in 8 (32%) and AT in 10 (40%) patients, the sensitivity of the latter being slightly superior to the former but inferior to the sensitivity reported in the literature for AT-echocardiography. One should also notice the positivity of AT-ECG in 6 (24%) patients, with negative or inconclusive ET, and the double product (DP) at ischemic threshold which was twice as low for AT-ECG as for ET-ECG, proving that AT induced ischemia by decreasing O2 myocardial input. It is concluded that AT-ECG is useful in myocardial ischemia detection in association with ET or in patients who cannot perform ET for different reasons.