Document Detail


Vasodilator stress impairs the left ventricular function obtained with gated single-photon emission computed tomography in patients with known or suspected coronary artery disease.
MedLine Citation:
PMID:  20966594     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Transient ischemic dilatation (TID) and post-stress dysfunction of the left ventricle (LV) are important markers of severe coronary artery disease (CAD). To clarify the effects of stressor type on TID and post-stress LV dysfunction, changes in LV measurements were compared between patients with exercise- or vasodilator-induced stress.
METHODS AND RESULTS: The 689 patients referred for technetium-99m tetrofosmin myocardial perfusion imaging were included. Patients were stressed with either a vasodilator (n=236) or exercise (n=453). LV measurements were obtained with ECG-gated SPECT. LV end-diastolic and end-systolic volume indexes (LVEDVI, LVESVI) increased and LV ejection fraction (LVEF) decreased after stress in the vasodilator-stress group. Vasodilator-stress and the summed difference score (SDS) were independent variables that decreased LVEF after stress. Even in patients without reversible defects, vasodilator-stress impaired LV function. There were no differences in the stress-to-rest ratios of LVEDVI (rEDV) and LVESVI (rESV) among patients with normal myocardial perfusion, fixed defects and reversible defects in the vasodilator-stress group, whereas in the exercise-stress group, rESV was significantly higher in the patients with reversible defects than in those without reversible defects. Within the vasodilator-stress group, neither rEDV nor rESV correlated with the SDS.
CONCLUSIONS: Vasodilator-stress by itself decreases LVEF after stress. TID should be carefully interpreted when vasodilator-stress is used to detect severe CAD.
Authors:
Keiichi Odagiri; Masashi Machii; Takamitsu Tanaka; Akihiko Uehara; Chinori Kurata; Harumi Sakahara; Yasuo Takehara; Masao Saotome; Tsuyoshi Urushida; Hideki Katoh; Hiroshi Satoh; Hideharu Hayashi
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-10-19
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  74     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-12-02     Completed Date:  2011-03-09     Revised Date:  2013-07-15    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  2666-73     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan. k-altair@nifty.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Coronary Artery Disease / radiography*
Exercise Test*
Female
Humans
Male
Middle Aged
Retrospective Studies
Tomography, Emission-Computed, Single-Photon*
Vasodilator Agents / administration & dosage*
Ventricular Dysfunction, Left / radiography
Ventricular Function, Left*
Chemical
Reg. No./Substance:
0/Vasodilator Agents
Comments/Corrections
Erratum In:
Circ J. 2013;77(6):1644
Note: Machii, Masashi [added]; Tanaka, Takamitsu [added]; Sakahara, Harumi [added]; Takehara, Yasuo [added]; Saotome, Masao [added]; Urushida, Tsuyoshi [added]; Katoh, Hideki [added]; Satoh, Hiroshi [added]; Hayashi, Hideharu [added]

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