| Postexercise VO2 "Hump" phenomenon as an indicator for inducible myocardial ischemia in patients with acute anterior myocardial infarction. | |
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MedLine Citation:
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PMID: 16203049 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: At exercise testing with respiratory gas analysis in patients with inducible myocardial ischemia, we have occasionally observed abnormal transient oxygen uptake (VO2) components with a characteristic "Hump"-shaped morphology early after exercise, which may serve as an index for inducible ischemia. We examined this hypothesis in patients with anterior q-wave myocardial infarction in whom the accuracy to identify ischemia by exercise ECG is limited. DESIGN: From patients with acute anterior q-wave infarction but without clinically overt heart failure who underwent pre-discharge exercise testing, we examined patients with (Group-I, n = 30) and without (Group-N, n = 29) inducible ischemia. To identify "Hump", postexercise VO2 (up to 4 min) standardized for peak VO2 was exponentially fitted with use of peak VO2 and VO2 of 90-240 s, yielding "expected VO2". "D-curve" was obtained by subtracting "expected VO2" from measured VO2. RESULTS: Although exercise-induced ST depressions more frequently appeared in Group-I (27%) than in Group-N (3%, p < 0.05), the prevalence was low. D-curve peaked later (p < 0.01) and its value was greater (p < 0.05) in Group-I than in Group-N. When "Hump" was defined to be present if D-curve peaked > or =40 s and its peak value > or =15%, it was far more frequently found in Group-I (n = 17/30) than in Group-N (n = 1/29, p < 0.01). Thus, "Hump" could diagnose inducible ischemia with a sensitivity of 57% and a specificity of 97%. CONCLUSIONS: Although not highly sensitive, postexercise VO2 "Hump" with its peak occurring around 60 s after exercise is a specific marker for inducible ischemia. The identification may be useful, particularly in patients with limited accuracy of exercise ECG such as those with q-wave anterior infarction. |
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Authors:
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Hiroshi Takaki; Satoru Sakuragi; Noritoshi Nagaya; Shoji Suzuki; Yoichi Goto; Takayuki Sato; Kenji Sunagawa |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2005-10-03 |
Journal Detail:
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Title: International journal of cardiology Volume: 111 ISSN: 0167-5273 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2006 Jul |
Date Detail:
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Created Date: 2006-07-31 Completed Date: 2007-01-03 Revised Date: - |
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: 67-74 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Dynamics, National Cardiovascular Center Research Institute, 5-7-1 Fujishiro-dai, Osaka, 565-8565, Japan. htakaki@res.ncvc.go.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Exercise Test* Female Humans Male Middle Aged Myocardial Infarction / complications* Myocardial Ischemia / diagnosis, etiology*, metabolism* Oxygen / metabolism* |
| Chemical | |
Reg. No./Substance:
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7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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