Document Detail


Raised exercise diastolic blood pressure as indicator of ischaemic left ventricular dysfunction.
MedLine Citation:
PMID:  1672979     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
F Akhras; G Jackson
Related Documents :
8737099 - Non-invasive prediction of reperfusion and coronary artery patency by continuous st seg...
15589009 - Assessment of derived 12-lead electrocardiograms using general and patient-specific rec...
16079919 - The effect of interventional treatment in acute myocardial infarction on st resolution:...
16501289 - Clinical characteristics of patients with exercise-induced st-segment elevation without...
1552269 - Effect of precision of st-segment measurement on identification and quantification of c...
12114839 - State of the art in stress testing and ischaemia monitoring.
11678729 - Dynamics of cardiac wound healing following myocardial infarction: observations in gene...
2790579 - Effect of n-acetylcysteine on tissue necrosis during acute myocardial infarction in rab...
12724629 - Use of the jarvik 2000 left ventricular assist system as a bridge to heart transplantat...
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    
Affiliation:
Department of Cardiology, Guy's Hospitals, London, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary
Blood Pressure / physiology*
Cardiac Output
Coronary Angiography
Coronary Artery Bypass
Coronary Disease / diagnosis,  physiopathology*,  therapy
Electrocardiography
Exercise Test*
Female
Follow-Up Studies
Heart Catheterization
Humans
Male
Middle Aged
Stroke Volume
Ventricular Function, Left / physiology*
Comments/Corrections
Comment In:
Lancet. 1991 Aug 31;338(8766):569   [PMID:  1678817 ]

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


Previous Document:  Clinical significance of small-intestinal microsporidiosis in HIV-1-infected individuals.
Next Document:  Molecular chaperones and protein translocation across the Escherichia coli inner membrane.