Document Detail


Subendocardial ischemia without coronary artery disease: is elevated left ventricular end diastolic pressure the culprit?
MedLine Citation:
PMID:  15140345     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim was to investigate the association between elevated left ventricular end diastolic pressure (LVEDP) and subendocardial ischemia. METHODS: A retrospective chart review was performed of 1846 consecutive patients admitted between January and September 2002 who had chest pain, stress testing and coronary angiography. RESULTS: 1592 patients were excluded due to a positive coronary angiogram for coronary artery disease (CAD), 254 patients had an angiogram compatible with non-significant CAD and an ejection fraction > 45%; of whom 210 (82.7%) had a positive stress test (study group) and the others 44 (17.3%) had a negative stress test (control group). The mean LVEDP value for the study group (11.8 +/- 6.1 mmHg) was significantly higher than the mean LVEDP value for the control group (7.8 +/- 4.6 mmHg) (p < 0.001). In addition, there were more people with abnormal LVEDP (>or= 12 mmHg) in the study group (n = 103, 49.05%) compared with the control group (n = 10, 22.73%) (p < 0.001). Furthermore, the results of logistic regression revealed that patients with abnormal LVEDP values were 11 times more likely to have had a positive stress test. CONCLUSIONS: There appears to be a positive association between elevated LVEDP and subendocardial ischemia that manifests as a positive stress test in patients without evidence of significant CAD.
Authors:
Abdul-Karim Elhabyan; Bernardo J Reyes; Omar Hallak; Mike Broce; James G Rosencrance; B Daniel Lucas; Hamid Fazal
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current medical research and opinion     Volume:  20     ISSN:  0300-7995     ISO Abbreviation:  Curr Med Res Opin     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-13     Completed Date:  2004-09-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0351014     Medline TA:  Curr Med Res Opin     Country:  England    
Other Details:
Languages:  eng     Pagination:  773-7     Citation Subset:  IM    
Affiliation:
CAMC Health Education and Research Institute, West Virginia University, Charleston Area Medical Center, Charleston, West Virginia 25304, USA.
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure
Chi-Square Distribution
Coronary Angiography
Diastole
Exercise Test
Female
Heart Ventricles / physiopathology*
Humans
Logistic Models
Male
Middle Aged
Myocardial Ischemia / physiopathology*
Retrospective Studies

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


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