| ST-segment depression during adenosine infusion as a predictor of myocardial ischemia. | |
| | |
MedLine Citation:
|
PMID: 8296697 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
The incidence and hemodynamic changes associated with ST-segment depression during adenosine stress testing are poorly defined. To examine this, 550 consecutive patients who underwent adenosine perfusion testing were evaluated for the development of ST-segment depression. At least 1 mm of horizontal or downsloping depression developed in 82 patients (15.9%) and was observed with similar frequency in patients with normal scans and those with only fixed defects. ST depression developed in 58 of 242 patients with reversible defects (sensitivity = 24%) and in only 24 of 275 patients without reversible defects (specificity = 91%). Its presence was highly predictive of reversible perfusion defects (predictive accuracy = 71%). Similar findings were observed in patients with and without ECG evidence of left ventricular hypertrophy. Patients with ST depression had perfusion defects in more vessel distributions, had more severe defects, and had a greater increase in heart rate during adenosine infusion. Thus ST-segment depression occurs infrequently during adenosine infusion but is specific for and predictive of myocardial ischemia, as evidenced by reversible perfusion scan defects. Patients with ST depression have more severe disease and develop faster heart rates during infusion, which could result in decreased coronary perfusion during diastole allowing for the development of myocardial ischemia. |
| | |
Authors:
|
E S Marshall; J S Raichlen; D A Tighe; J J Paul; K M Breuninger; E K Chung |
Related Documents
:
|
1304417 - Correlation of coronary artery stenosis site with anterior or inferior projection of st... 16368287 - Combination of quantitative st deviation and troponin elevation provides independent pr... 20462897 - Time to stable st-segment recovery following primary angioplasty is predictive of regio... 9854657 - Detection of postoperative myocardial ischemia by bedside st-segment analysis in corona... 20339497 - Left ventricular function in children and adolescents with type 1 diabetes mellitus. 12956627 - Coronary vasomotor response is related to the angiographic extent of coronary sclerosis... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: American heart journal Volume: 127 ISSN: 0002-8703 ISO Abbreviation: Am. Heart J. Publication Date: 1994 Feb |
Date Detail:
|
Created Date: 1994-03-03 Completed Date: 1994-03-03 Revised Date: 2006-02-27 |
Medline Journal Info:
|
Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 305-11 Citation Subset: AIM; IM |
Affiliation:
|
Division of Cardiology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adenosine
/
administration & dosage,
diagnostic use* Aged Angina Pectoris / chemically induced, physiopathology Blood Pressure / drug effects, physiology Coronary Circulation / drug effects, physiology Diastole Electrocardiography / drug effects* Exercise Test* / methods Female Forecasting Heart Rate / drug effects, physiology Humans Hypertrophy, Left Ventricular / diagnosis, physiopathology Infusions, Intravenous Male Middle Aged Myocardial Ischemia / diagnosis*, physiopathology, radionuclide imaging Radionuclide Ventriculography Sensitivity and Specificity Technetium Tc 99m Sestamibi / diagnostic use Thallium Radioisotopes / diagnostic use |
| Chemical | |
Reg. No./Substance:
|
0/Thallium Radioisotopes; 109581-73-9/Technetium Tc 99m Sestamibi; 58-61-7/Adenosine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Population selection and performance of the exercise ECG for the identification of coronary artery d...
Next Document: Investigation of therapeutic mechanisms of atenolol and diltiazem in patients with variable-threshol...