Document Detail

Detection of coronary artery disease in aortic stenosis by exercise gated nuclear angiography.
MedLine Citation:
PMID:  6486029     Owner:  NLM     Status:  MEDLINE    
Because the clinical diagnosis of coronary artery disease (CAD) in the presence of aortic stenosis (AS) is difficult, the value of exercise gated nuclear angiography in detecting CAD in 33 patients with AS was assessed. Exercise left ventricular (LV) ejection fraction (EF) and wall motion analysis were evaluated after symptom-limited supine cycle ergometer exercise. Sixteen patients had severe AS (valve area 0.8 cm2 or less). Thirteen had significant associated CAD (50% or greater reduction in luminal diameter of 1 major coronary artery). Twenty patients had normal coronary arteriograms. All 10 patients with mild to moderate AS and normal coronary arteries had normal nuclear studies. Patients with CAD, regardless of the severity of AS, had a decrease in LVEF during exercise (12 of 13 patients) and regional wall motion abnormalities (11 of 13 patients). Abnormal exercise gated nuclear ventriculographic studies occurred in the absence of CAD in 10 of 20 patients, and all had severe AS (mean aortic valve area 0.8 cm2 or less, range 0.4 to 0.8). Ten had an abnormal LVEF response to exercise and 7 had exercise-induced abnormal wall motion. These findings suggest that the presence of an abnormal LVEF, whether in conjunction with an abnormal wall motion analysis, is indicative of further invasive evaluation; conversely, in those patients with a normal response of LVEF and normal wall motion during exertion, invasive studies may be safely deferred.
J C Milanes; J Paldi; M Romero; D Goodwin; H N Hultgren
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The American journal of cardiology     Volume:  54     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1984 Oct 
Date Detail:
Created Date:  1984-11-02     Completed Date:  1984-11-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  787-91     Citation Subset:  AIM; IM    
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MeSH Terms
Aortic Valve Stenosis / complications*,  physiopathology,  radionuclide imaging
Cardiac Output*
Coronary Disease / complications,  physiopathology,  radionuclide imaging*
Exercise Test
Heart Catheterization
Middle Aged
Myocardial Contraction
Stroke Volume*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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