{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:23:18Z","timestamp":1791919398685,"version":"4.3.4"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1997,12,16]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            Myocardial ischemia may play a role in the natural history of hypertrophic cardiomyopathy (HCM). To assess the relative prevalence and the prognostic value of dipyridamole-induced ischemia, 79 patients with HCM and without concomitant coronary artery disease (53 men; mean age, 46\u00b115 years) underwent a high-dose (up to 0.84 mg\/kg over 10 minutes) dipyridamole test with 12-lead ECG and two-dimensional echo monitoring and were followed up for a mean of 6 years.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            Twenty-nine patients (37%) showed ECG (ie, ST depression \u22652 mV) signs of myocardial ischemia during dipyridamole test (group 1), whereas 50 (63%) had a negative test (group 2). No patient had transient wall motion abnormalities during the dipyridamole test. During the follow-up, 16 events (ie, left ventricular or atrial enlargement, unstable angina, syncope, atrial fibrillation, and bundle-branch block) occurred in 29 patients in group 1 and 5 in 50 patients in group 2 (55% versus 10%,\n            <jats:italic>P<\/jats:italic>\n            &lt;.001). Patients with a positive dipyridamole test showed worse 72-month event-free survival rates compared with patients with a negative test (36.2% versus 84.2%,\n            <jats:italic>P<\/jats:italic>\n            &lt;.001). A forward stepwise event-free survival analysis identified dipyridamole test positivity by ECG criteria (\u03c7\n            <jats:sup>2<\/jats:sup>\n            =19.7,\n            <jats:italic>P<\/jats:italic>\n            =.0001), rest gradient (\u03c7\n            <jats:sup>2<\/jats:sup>\n            =11.3,\n            <jats:italic>P<\/jats:italic>\n            =.0008), and age (\u03c7\n            <jats:sup>2<\/jats:sup>\n            =4.1;\n            <jats:italic>P<\/jats:italic>\n            =.0413) as independent and additive predictors of subsequent events.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            ECG signs of myocardial ischemia elicited by dipyridamole are frequent in patients with HCM and identify patients at higher risk of cardiac events, suggesting a potentially important pathogenetic role of inducible myocardial ischemia in determining adverse cardiac events in these patients.\n          <\/jats:p>","DOI":"10.1161\/01.cir.96.12.4268","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:41:02Z","timestamp":1339461662000},"page":"4268-4272","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":56,"title":["Dipyridamole-Induced Ischemia as a Prognostic Marker of Future Adverse Cardiac Events in Adult Patients With Hypertrophic Cardiomyopathy"],"prefix":"10.1161","volume":"96","author":[{"given":"Ettore","family":"Lazzeroni","sequence":"first","affiliation":[{"name":"From the Division of Cardiology, Parma Hospital, and CNR Institute of Clinical Physiology (E.P.), Pisa, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenio","family":"Picano","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Parma Hospital, and CNR Institute of Clinical Physiology (E.P.), Pisa, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia","family":"Morozzi","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Parma Hospital, and CNR Institute of Clinical Physiology (E.P.), Pisa, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Rita","family":"Maurizio","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Parma Hospital, and CNR Institute of Clinical Physiology (E.P.), Pisa, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giampaolo","family":"Palma","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Parma Hospital, and CNR Institute of Clinical Physiology (E.P.), Pisa, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Ceriati","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Parma Hospital, and CNR Institute of Clinical Physiology (E.P.), Pisa, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilio","family":"Iori","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Parma Hospital, and CNR Institute of Clinical Physiology (E.P.), Pisa, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Barilli","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Parma Hospital, and CNR Institute of Clinical Physiology (E.P.), Pisa, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"(EPIC) Study Group, Subproject Hypertrophic Cardiomyopathy ;","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Parma Hospital, and CNR Institute of Clinical Physiology (E.P.), Pisa, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198903233201201"},{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198903233201201"},{"key":"e_1_3_1_3_2","doi-asserted-by":"crossref","unstructured":"Maron BJ Cecchi F McKenna WJ. 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