Pattern of exercise-induced ST change is related to coronary flow reserve in patients with chest pain and normal coronary angiogram
In: International journal of cardiology, Jg. 101 (2005), Heft 2, S. 299-304
academicJournal
- print, 32 ref
Zugriff:
Objective: To evaluate the usefulness of exercise treadmill test in determining the true microvasculature-induced ischemia, we compared the pattern of ST depression with coronary flow reserve (CFR) using transthoracic Doppler echocardiography (TTE) in patients with chest pain and normal coronary angiogram. Design: Fifty-nine subjects (M/F = 21:38, mean age 55 ± 9 years) with chest pain and normal coronary angiogram underwent maximal symptom-limited exercise treadmill test (ETT). CFR was estimated with TTE and dipyridamole. Patients with a history of acute myocardial infarction, regional wall motion abnormalities, hypertrophic cardiomyopathy, ejection fraction less than 50%, or primary valvular heart disease were excluded from this study. Results: No ST change was observed in 20 of 59 (34%) patients, up slope depression was observed in 20 (34%), flat depression in 13 (22%), and down slope depression in 6 (10%). Eleven of thirty nine (28%) exercise positive patients had decreased CFR <2.1. CFR was 3.1 ± 0.6 in group with no ST change, 3.1 ± 0.6 in group with up slope depression, 2.1 ± 0.6 in group with flat depression (p < 0.05 versus group with no change and group with upslope depression, respectively), and 2.0 ± 0.4 in group with down slope depression (p < 0.05 versus group with no change and group with up slope depression, respectively). Flat to down slope depression of ST change during ETT had sensitivity of 58% and specificity of 95% for predicting CFR <2.1. Conclusion: Flat and down slope depression of ST segment during ETT might increase the sensitivity and specificity to detect the true microvasculature-induced ischemia that is defined as CFR less than 2.1 in patients with chest pain and normal coronary angiogram.
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Pattern of exercise-induced ST change is related to coronary flow reserve in patients with chest pain and normal coronary angiogram
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Autor/in / Beteiligte Person: | YOUN, Ho-Joong ; PARK, Chul-Soo ; HONG, Soon-Jo ; CHO, Eun-Joo ; JUNG, Hae-Ok ; JEON, Hui-Kyung ; LEE, Jong-Min ; OH, Yong-Seok ; CHUNG, Wook-Sung ; KIM, Jae-Hyung ; CHOI, Kyu-Bo |
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Zeitschrift: | International journal of cardiology, Jg. 101 (2005), Heft 2, S. 299-304 |
Veröffentlichung: | Shannon: Elsevier Science, 2005 |
Medientyp: | academicJournal |
Umfang: | print, 32 ref |
ISSN: | 0167-5273 (print) |
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