| Pattern of exercise-induced ST change is related to coronary flow reserve in patients with chest pain and normal coronary angiogram. | |
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MedLine Citation:
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PMID: 15882679 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the usefulness of exercise treadmill test in determining the true microvasculature-induced ischemia, we compared the pattern of ST depression with coronary flow reserve (CFR) using transthoracic Doppler echocardiography (TTE) in patients with chest pain and normal coronary angiogram. DESIGN: Fifty-nine subjects (M/F=21:38, mean age 55+/-9 years) with chest pain and normal coronary angiogram underwent maximal symptom-limited exercise treadmill test (ETT). CFR was estimated with TTE and dipyridamole. Patients with a history of acute myocardial infarction, regional wall motion abnormalities, hypertrophic cardiomyopathy, ejection fraction less than 50%, or primary valvular heart disease were excluded from this study. RESULTS: No ST change was observed in 20 of 59 (34%) patients, up slope depression was observed in 20 (34%), flat depression in 13 (22%), and down slope depression in 6 (10%). Eleven of thirty nine (28%) exercise positive patients had decreased CFR <2.1. CFR was 3.1+/-0.6 in group with no ST change, 3.1+/-0.6 in group with up slope depression, 2.1+/-0.6 in group with flat depression (p<0.05 versus group with no change and group with upslope depression, respectively), and 2.0+/-0.4 in group with down slope depression (p<0.05 versus group with no change and group with up slope depression, respectively). Flat to down slope depression of ST change during ETT had sensitivity of 58% and specificity of 95% for predicting CFR <2.1. CONCLUSION: Flat and down slope depression of ST segment during ETT might increase the sensitivity and specificity to detect the true microvasculature-induced ischemia that is defined as CFR less than 2.1 in patients with chest pain and normal coronary angiogram. |
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Authors:
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Ho-Joong Youn; Chul-Soo Park; Eun-Joo Cho; Hae-Ok Jung; Hui-Kyung Jeon; Jong-Min Lee; Yong-Seok Oh; Wook-Sung Chung; Jae-Hyung Kim; Kyu-Bo Choi; Soon-Jo Hong |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: International journal of cardiology Volume: 101 ISSN: 0167-5273 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2005 May |
Date Detail:
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Created Date: 2005-05-10 Completed Date: 2005-09-13 Revised Date: 2006-07-12 |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Ireland |
Other Details:
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Languages: eng Pagination: 299-304 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, College of Medicine, The Catholic University of Korea, #62 Yoido-dong, Youngdungpo-ku, St. Mary's Hospital, Seoul, 150-713, South Korea. younhj@catholi.ac.kr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Blood Flow Velocity Cardiac Output / physiology* Echocardiography, Doppler Electrocardiography* Exercise / physiology* Exercise Test* Female Humans Male Microvascular Angina / diagnosis*, physiopathology*, ultrasonography Middle Aged Sensitivity and Specificity |
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