Document Detail


Evaluation of left ventricular contractility indexes for the detection of symptomatic and silent myocardial ischemia.
MedLine Citation:
PMID:  3195478     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study evaluated the role of left ventricular (LV) ejection fraction and systolic blood pressure (BP) to end-systolic volume ratio to detect symptomatic and silent myocardial ischemia. The sensitivity and diagnostic accuracy of these contractility indexes were compared with angina and ST depression during exercise. Thirty consecutive patients referred for chest pain performed symptom-limited bicycle exercise and had coronary angiography within 3 months. Twenty-two had angiographically significant coronary artery disease and 8 had normal coronary anatomy. Systolic BP was measured by sphygmomanometry; LV ejection fraction and end-systolic volume were obtained by nuclear ventriculography. Normal values for contractility indexes were defined as LV ejection fraction greater than 52% at rest and increment of greater than or equal to 5% during exercise, and systolic BP to end-systolic volume ratio greater than 2.2 mm Hg/ml at rest and greater than 3.0 mm Hg/ml during exercise. The sensitivity of systolic BP to end-systolic volume ratio to identify patients with coronary artery disease at rest was 71 vs 33% for LV ejection fraction. During exercise, each contractility index had a sensitivity of 95% and there was a combined sensitivity of 100%. This compares with 71% for ST depression and 48% for exercise-induced angina. Thus, 52% had no angina and 36% of them were also silent by electrocardiography. Among the patients with symptomatic ischemia, 20% had no ST-segment depression. Measurement of contractility indexes enhanced the detection of silent myocardial ischemia and provided information on LV function vital to prognosis and management of patients with coronary artery disease.
Authors:
M F Wilson; B H Sung; C P Herbst; R H Lee; D J Brackett
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The American journal of cardiology     Volume:  62     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1988 Dec 
Date Detail:
Created Date:  1989-01-03     Completed Date:  1989-01-03     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:  1176-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angina Pectoris / physiopathology
Blood Pressure*
Cardiac Output
Coronary Disease / diagnosis*,  physiopathology
Exercise Test
Heart Rate
Humans
Male
Middle Aged
Myocardial Contraction*
Stroke Volume*
Systole

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


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