Document Detail

ST/HR slope during prostacyclin treatment: an improved method to identify patients with advanced coronary artery disease.
MedLine Citation:
PMID:  2480239     Owner:  NLM     Status:  MEDLINE    
Constriction of atherosclerotic coronary segments during exercise may further reduce coronary flow reserve in patients with coronary artery disease. This could influence the linear regression analysis of the heart rate-related changes in ST-segment depression (ST/HR slope) thereby limiting the accuracy of this method in identifying the severity of the disease. To test this hypothesis, the exercise related ST/HR slopes on placebo were compared with those obtained during coronary vasodilation induced by a prostacyclin analogue (iloprost 6 ng kg-1 min-1) in 42 anginal patients with documented coronary artery disease. In seven of these, the same protocol was repeated during right heart catheterization. The overall diagnostic accuracy of the ST/HR slope on iloprost was better than on placebo in patients with advanced coronary artery disease. This was due mainly to a consistent rightward shift of the ST/HR slope in patients with one- and two-vessel, but not three-vessel disease or left main stem disease. The reason for the greater effects of iloprost on ST/HR slopes in patients with a lesser degree of atherosclerosis remains unclear. However, coronary blood flow was higher during drug infusion, which suggests that iloprost may prevent the occurrence of dynamic coronary events able to reduce the maximum coronary flow reserve during exertion. This mechanism may be predominant in patients with minor coronary artery disease.
R Bugiardini; A Borghi; G Morgagni; A Pozzati; F Ottani; F A Nicolini; P Puddu
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  10     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1989 Nov 
Date Detail:
Created Date:  1990-01-22     Completed Date:  1990-01-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  991-7     Citation Subset:  IM    
Institute of Patologia Medica, University of Bologna, Italy.
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MeSH Terms
Angina Pectoris / drug therapy
Cardiovascular Agents / therapeutic use*
Clinical Trials as Topic
Coronary Artery Disease / drug therapy
Coronary Circulation / drug effects
Coronary Disease / drug therapy*
Electrocardiography / drug effects*
Epoprostenol / therapeutic use*
Exercise Test*
Heart Rate / drug effects*
Middle Aged
Single-Blind Method
Reg. No./Substance:
0/Cardiovascular Agents; 35121-78-9/Epoprostenol; 78919-13-8/Iloprost

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

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