Document Detail


The value of hemodynamic changes induced by carotid sinus massage on the diagnosis of coronary artery disease.
MedLine Citation:
PMID:  11666135     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study is to investigate the value of hemodynamic changes induced by carotid sinus massage (CSM) on the diagnosis of coronary artery disease (CAD). A total 108 patients (mean age, 54 +/- 10 years, range 33-70) who had no significant stenosis in the carotid artery by duplex ultrasonography (USG) and no history of syncope were included in this study. Carotid sinus massage was performed before coronary angiography with monitoring of electrocardiography and blood pressure. The patients were divided into three groups according to response to CSM: group 1 patients had a decrease in blood pressure or < 10 beats/minute (bpm); group 2 patients had a decrease between 10 and 20 bpm; and group 3 patients had > 20 mm Hg decrease in blood pressure or > 20 bpm. Coronary angiography was performed after CSM in all patients. There was single-vessel disease (VD) in 23 cases, two-VD in 24 cases, and three-VD in 35 cases. Coronary angiography results were normal in 26 cases. The changes in systolic and diastolic blood pressures and heart rate before and after CSM correlated with number of VD. These changes were highest in patients with three-VD, but lowest in patients with normal coronary angiography. The number of diseased vessels and total coronary artery score were lowest in group 1, but highest in group 3. The specificity and sensitivity of CSM-induced > 10 mm Hg in blood pressure (BP) or > 10 bpm changes in heart rate in the diagnosis of CAD were 85% and 71%, respectively. The positive and negative predictive values were 93% and 49%, respectively in the diagnosis of CAD. At the end of this study, we concluded that CSM induced the fall in blood pressure and heart rate and was correlated with number of diseased vessels and the score of coronary artery disease. As dichotomized values, the decrease of > 10 mm Hg in blood pressure and/or > 10 bpm has highest specificity, sensitivity, and positive predictive value in the diagnosis of CAD.
Authors:
M S Ulgen; A Karadede; S Alan; N Toprak
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Angiology     Volume:  52     ISSN:  0003-3197     ISO Abbreviation:  Angiology     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-10-22     Completed Date:  2001-12-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0203706     Medline TA:  Angiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  703-9     Citation Subset:  IM    
Affiliation:
Faculty of Medicine, Department of Cardiology, Dicle University, Diyarbakir, Turkey. Ulgen@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analysis of Variance
Blood Pressure / physiology
Carotid Sinus / physiopathology*,  radiography
Coronary Angiography
Coronary Artery Disease / physiopathology*,  radiography*
Electrocardiography
Female
Heart Rate / physiology
Hemodynamics / physiology*
Humans
Male
Massage*
Middle Aged
Predictive Value of Tests
Prospective Studies
Sensitivity and Specificity
Stroke Volume / physiology

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


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