| Raised exercise diastolic blood pressure as indicator of ischaemic left ventricular dysfunction. | |
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MedLine Citation:
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PMID: 1672979 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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F Akhras; G Jackson |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Lancet Volume: 337 ISSN: 0140-6736 ISO Abbreviation: Lancet Publication Date: 1991 Apr |
Date Detail:
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Created Date: 1991-05-10 Completed Date: 1991-05-10 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 2985213R Medline TA: Lancet Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 899-900 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, Guy's Hospitals, London, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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Lancet. 1991 Aug 31;338(8766):569
[PMID:
1678817
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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