Document Detail

Raised exercise diastolic blood pressure as indicator of ischaemic left ventricular dysfunction.
MedLine Citation:
PMID:  1672979     Owner:  NLM     Status:  MEDLINE    
91 (16.8%) of 541 consecutive patients investigated for chest pain or after recent uncomplicated myocardial infarction had a rise in diastolic blood pressure (DBP) of more than 15 mm Hg during a symptom-limited treadmill test. 63 also had electrocardiographic evidence of ischaemia, but 28 did not have 1 mm ST segment depression, of whom 24 had angiographic evidence of more than 70% stenosis of two or more major coronary arteries. 55 of these 91 patients underwent coronary artery bypass surgery; repeat angiography in 22 at 12 months showed an improved left ventricular ejection fraction in 18 who had a normal postoperative DBP response, but no change in ejection fraction in the 4 who still had an abnormal rise in DBP on exercise. Exercise-induced ischaemia may cause a reversible fall in cardiac output that sometimes leads to reflex vasoconstriction and a rise in DBP before a fall in systolic blood pressure or ECG evidence of ST segment depression. An abnormal DBP response to exercise may identify some patients at high risk of myocardial infarction who might otherwise have false-negative exercise tests.
F Akhras; G Jackson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Lancet     Volume:  337     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  1991 Apr 
Date Detail:
Created Date:  1991-05-10     Completed Date:  1991-05-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  899-900     Citation Subset:  AIM; IM    
Department of Cardiology, Guy's Hospitals, London, UK.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary
Blood Pressure / physiology*
Cardiac Output
Coronary Angiography
Coronary Artery Bypass
Coronary Disease / diagnosis,  physiopathology*,  therapy
Exercise Test*
Follow-Up Studies
Heart Catheterization
Middle Aged
Stroke Volume
Ventricular Function, Left / physiology*
Comment In:
Lancet. 1991 Aug 31;338(8766):569   [PMID:  1678817 ]

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

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