June 1, 1981
Ver artículo completoLeft ventricular diastolic performance at rest and during exercise in patients with coronary artery disease. Assessment with first-pass radionuclide angiography.
PICO estructurado
Does first-pass radionuclide angiocardiography detect differences in left ventricular diastolic performance at rest and during exercise between normal patients and those with coronary artery disease?
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Población
100 patients, comprising 32 normal patients and 68 patients with coronary artery disease (including 49 with normal resting ejection fraction ≥50%).
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Intervención
First-pass radionuclide angiocardiography at rest and after upright bicycle exercise.
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Comparador
Normal patients (n=32) compared to patients with coronary artery disease (n=68).
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Resultado
Left ventricular diastolic performance indexes (filling fraction during the first third of diastole, peak filling rate, and peak filling rate during the first third of diastole).surrogate
First-pass radionuclide angiocardiography demonstrates that patients with coronary artery disease frequently have early diastolic dysfunction at rest despite normal systolic function, which worsens during exercise-induced ischemia.
Resumen
We used first-pass radionuclide angiocardiography to assess filling fraction during the first third of diastole, peak filling rate and peak filling rate during the first third of diastole as indexes of left ventricular diastolic performance at rest and after upright bicycle exercise in 32 normal patients and 68 patients with coronary artery disease. The mean filling fraction was unchanged from rest to exercise in normal patients (47+/- 15% vs 46 +/- 13%; NS). Even in 49 coronary patients with normal (greater than or equal to 50%) ejection fraction at rest, filling fraction was less than that in normal patients at rest (35 +/- 11% vs 47 +/- 15%, p less than 0.001). Despite similar resting heart rates, patients with coronary disease had lower (p less than 0.001) peak filling rate and peak filling rate during the first third of diastole than normal patients. With exercise, filling fraction decreased (p less than 0.001) from the resting value in coronary patients. These data suggest that (1) indexes of diastolic performance can be noninvasively assessed at rest and during exercise using first-pass radionuclide angiocardiography, (2) abnormalities in early diastolic performance are often present at rest in patients with coronary artery disease despite normal systolic performance, and (3) exercise-induced ischemia results in increased early diastolic dysfunction in patients with coronary disease.