Document Detail

Mechanism of exercise-induced hypotension in coronary artery disease.
MedLine Citation:
PMID:  1598863     Owner:  NLM     Status:  MEDLINE    
Hypotension during exercise testing has been considered a marker of extensive coronary artery disease (CAD) and poor prognosis. The mechanism of hypotension was examined in 25 CAD patients who developed hypotension during treadmill exercise testing (mean decrease in systolic blood pressure [BP] 33 +/- 13 mm Hg) (group 1) and was compared with the results of 25 CAD patients who had a normal systolic BP response to exercise (mean increase 53 +/- 15 mm Hg) (group 2). The 2 groups were comparable in age, sex, extent of CAD, previous myocardial infarction, left ventricular ejection fraction, history of hypertension and cardiac medications. Exercise heart rate (121 +/- 23 vs 133 +/- 25 beats/min; p = not significant [NS]) and duration (6 +/- 2 vs 7 +/- 3 minutes; p = NS) were comparable. ST-segment depression occurred in 44% of patients in group 1 and in 52% in group 2 (p = NS), and angina during exercise occurred in 60% of both groups. Single-photon emission computed tomographic thallium images were abnormal in 24 patients (96%) in group 1 and in 20 patients (80%) in group 2 (p = NS). Percent thallium abnormality was 19 +/- 12% in group 1, and 18 +/- 14% in group 2 (p = NS), and the severity of thallium abnormality was 710 +/- 510 in group 1, and 510 +/- 500 in group 2 (p = NS). Ischemia involving the inferior/posterior segments was seen in 68% of patients in group 1 and in 60% in group 2 (p = NS). Increased lung thallium uptake was seen in 48% of both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
A S Iskandrian; J G Kegel; J Lemlek; J Heo; V Cave; B Iskandrian
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  69     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1992 Jun 
Date Detail:
Created Date:  1992-07-09     Completed Date:  1992-07-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1517-20     Citation Subset:  AIM; IM    
Philadelphia Heart Institute, Presbyterian Medical Center, Pennsylvania 19104.
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MeSH Terms
Blood Pressure / physiology
Cardiac Output / physiology
Coronary Angiography
Coronary Disease / complications*,  physiopathology,  radiography,  radionuclide imaging
Exercise Test*
Heart Rate / physiology
Hypotension / etiology*,  physiopathology
Middle Aged
Myocardial Infarction / physiopathology
Thallium Radioisotopes / diagnostic use
Tomography, Emission-Computed, Single-Photon
Ventricular Function, Left / physiology
Reg. No./Substance:
0/Thallium Radioisotopes

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

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