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Exercise-induced ST-segment depression in patients without restenosis after coronary angioplasty. Relation to preprocedural impaired left ventricular function.
- Source :
-
Circulation [Circulation] 1994 Jul; Vol. 90 (1), pp. 148-55. - Publication Year :
- 1994
-
Abstract
- Background: ST-segment depression during exercise testing is frequently observed in the absence of restenosis after coronary angioplasty.<br />Methods and Results: We studied the determinants of this phenomenon in 70 consecutive patients with unstable angina related to a single left anterior descending coronary artery lesion who had successful angioplasty without restenosis (< 50% stenosis by quantitative angiography). We compared preangioplasty clinical, angiographic, and hemodynamic variables in the group with positive (ExT Pos, n = 35; ST depression, 2.3 +/- 0.9 mm) and negative (ExT Neg, n = 35; ST depression, 0.3 +/- 0.5 mm) results on exercise testing at follow-up angiography. At this time, minimal lumen diameter (1.7 +/- 0.4 mm) and mean residual stenosis (34 +/- 11%) in the ExT Pos group were not significantly different from the values (1.9 +/- 0.5 mm, 38 +/- 10%) in the ExT Neg group. Before angioplasty, the ExT Pos group had a lower ejection fraction (63 +/- 8% versus 68 +/- 9%, P < .05), more marked anterior hypokinesis estimated by the extent of anterior wall contraction on quantitative ventriculography (P < .05), and a greater end-systolic volume (30 +/- 11 versus 25 +/- 9 mL/m2, P < .05) than the ExT Neg group. At follow-up angiography, regional anterior wall motion was normal in 68 patients (97%). Anterior hypokinesis before angioplasty was strongly associated (P < .01) with a positive exercise test at control (71% compared with 31% in patients with normal wall motion before angioplasty).<br />Conclusions: In the absence of significant epicardial stenosis after angioplasty, ST-segment depression is strongly associated with the presence of preprocedural regional ventricular dysfunction that has recovered at follow-up angiography.
Details
- Language :
- English
- ISSN :
- 0009-7322
- Volume :
- 90
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Circulation
- Publication Type :
- Academic Journal
- Accession number :
- 8025990
- Full Text :
- https://doi.org/10.1161/01.cir.90.1.148