Document Detail


Predictors of exercise induced myocardial ischemia in patients with isolated coronary artery ectasia.
MedLine Citation:
PMID:  15055816     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to investigate the angiographic predictors of exercise induced ischemia in patients with isolated coronary ectasia. We have prospectively analysed coronary angiograms of 1521 consecutive patients undergoing cardiac catheterisation. The overall incidence of coronary ectasia was 6.7% (102 patients). Forty-six patients (3%) with non-obstructive, diffuse or segmental coronary ectasia (i.e. isolated coronary ectasia) constituted the main study group. Coronary angiograms were reviewed for stigmata of an impaired coronary blood flow such as 'slow flow', 'segmental backflow phenomenon' and stasis. 'Slow flow' was quantified with frame counting. An ectasia-jeopardy score was also described in order to assess the effect of the extent of coronary ectasia on exercise induced ischemia. Exercise induced ischemia was observed in 24 patients (52%). Exercise test was abnormal in 70% of the patients with diffuse ectasia and 26% of patients with segmental ectasia (p = 0.003). The frame count of the arteries of the study group was higher than the control group but the correlation between the frame count of the ectatic vessels and exercise induced ischemia was not significant. Stasis of the dye also did not correlate with ischemia. There was a significant correlation between exercise induced ischemia and backflow phenomenon in left anterior descending artery (LAD) (r = 0.56, p = 0.0001). Exercise induced ischemia was best correlated with the ectasia-jeopardy score (r = 0.77, p = 0.0001) and a score of > or =4 identified the patients at risk with 90% sensitivity and 80% specificity. In conclusion, the extent of the ectasia within the coronary tree, diffuse ectasia and backflow-phenomenon in LAD were identified as the most important predictors of exercise induced ischemia.
Authors:
Ahmet Altinbas; Cem Nazli; Ozan Kinay; Oktay Ergene; Omer Gedikli; Mehmet Ozaydin; Abdullah Dogan; Gurhan Gunay
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The international journal of cardiovascular imaging     Volume:  20     ISSN:  1569-5794     ISO Abbreviation:  Int J Cardiovasc Imaging     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-04-01     Completed Date:  2004-07-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100969716     Medline TA:  Int J Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3-17     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Sevket Demirel Heart Center, Suleyman Demirel University Medical School, Isparta, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Chi-Square Distribution
Coronary Angiography
Coronary Vessel Anomalies / complications*,  physiopathology,  radiography*
Dilatation, Pathologic / complications,  radiography
Electrocardiography
Exercise / physiology*
Exercise Test
Female
Heart Catheterization
Humans
Male
Middle Aged
Myocardial Ischemia / diagnosis*,  etiology*
Predictive Value of Tests
Prospective Studies
Severity of Illness Index
Statistics, Nonparametric
Vascular Patency

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


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