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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
- Source :
- International journal of cardiology. 101(2)
- Publication Year :
- 2003
-
Abstract
- 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.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.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 CFR2.1. 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 (p0.05 versus group with no change and group with upslope depression, respectively), and 2.0+/-0.4 in group with down slope depression (p0.05 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 CFR2.1.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.
- Subjects :
- Thorax
Male
medicine.medical_specialty
Doppler echocardiography
Chest pain
Sensitivity and Specificity
Electrocardiography
Internal medicine
medicine
ST segment
Humans
Myocardial infarction
Cardiac Output
Exercise
Aged
Microvascular Angina
ST depression
Ejection fraction
medicine.diagnostic_test
business.industry
Coronary flow reserve
Middle Aged
medicine.disease
Echocardiography, Doppler
Cardiology
Exercise Test
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Blood Flow Velocity
Subjects
Details
- ISSN :
- 01675273
- Volume :
- 101
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- International journal of cardiology
- Accession number :
- edsair.doi.dedup.....58fea902e55aac52c0acb999069b39c3