Document Detail


Multistage analysis of exercise radionuclide angiography in coronary artery disease.
MedLine Citation:
PMID:  3728329     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The hypothesis that serial assessment of left ventricular function during exercise radionuclide angiography provides improved diagnostic criteria for coronary artery disease (CAD) was examined. Fifty-eight consecutive patients without previous myocardial infarction were prospectively scheduled for cardiac catheterization and multistage radionuclide angiographic exercise studies. Forty-one patients had significant CAD. The traditional criterion--failure to achieve a 5% increment in ejection fraction (EF) during exercise compared with the value at rest--had 85% sensitivity but only 41% specificity for CAD. In 12 patients, EF increased early in exercise by at least 4% and then decreased a mean of 7.5%, often with worsening regional wall motion. This "up-down" EF pattern was applied as a diagnostic test in the overall study group. Analysis of changes in EF from the maximal value achieved to that at the end of exercise resulted in criteria with greater sensitivity (p less than 0.0001) for CAD than analysis of changes from rest, with similar specificity. Regional wall motion abnormalities occurring during the first exercise stage resulted in 94% specificity for CAD (p = 0.05 vs end-stage analysis), although sensitivity was low. Analyzing the maximal EF during exercise results in improved sensitivity, while analyzing the early onset of regional dysfunction results in high specificity for CAD.
Authors:
R M Schneider; W S Weintraub; L W Klein; P A Seelaus; R I Katz; J B Agarwal; R H Helfant
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  58     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1986 Jul 
Date Detail:
Created Date:  1986-08-18     Completed Date:  1986-08-18     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:  36-41     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Coronary Disease / physiopathology,  radionuclide imaging*
Exercise Test
Female
Heart / physiopathology,  radionuclide imaging*
Humans
Male
Middle Aged
Myocardial Contraction
Stroke Volume

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


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