What question did this study set out to answer?

Evaluate exercise left ventricular performance and myocardial perfusion in patients presenting with chest pain and ischemic-appearing electrocardiograms despite angiographically normal coronary arteries.

February 1, 1981Annals of Internal Medicine

Exercise Left Ventricular Performance in Patients with Chest Pain, Ischemic-Appearing Exercise Electrocardiograms, and Angiographically Normal Coronary Arteries

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Why the study?

Does exercise induce left ventricular dysfunction in patients with chest pain, ischemic-appearing exercise electrocardiograms, and angiographically normal coronary arteries?

Population

31 patients with chest pain, an ischemic-appearing exercise electrocardiogram, and angiographically normal…

Design

Cross-sectional

Authors

HBHarvey J. BergerAmerican College of Cardiology

Discussion

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Implication

Exercise-induced LV dysfunction may occur despite normal coronaries; hypothesis-generating and should not yet change practice.

Key Points

Evaluate exercise left ventricular performance and myocardial perfusion in patients presenting with chest pain and ischemic-appearing electrocardiograms despite angiographically normal coronary arteries.
Assessed resting and maximal upright bicycle exercise left ventricular performance using first-pass radionuclide angiocardiography in 31 patients.
Performed treadmill exercise thallium-201 imaging in all 31 patients and ergonovine provocation testing in 9 selected patients.
Resting left ventricular performance was normal in all 31 patients, but an abnormal ejection fraction response during exercise occurred in 12 of 31 patients (38.7%).
Exercise-induced regional wall-motion dysfunction developed in 4 patients (all with abnormal global responses), and thallium-201 perfusion defects appeared in 5 of 31 patients (16.1%).
Ergonovine provocation produced no evidence of coronary arterial spasm in any of the 9 patients tested.

Structured PICO

Does exercise induce left ventricular dysfunction in patients with chest pain, ischemic-appearing exercise electrocardiograms, and angiographically normal coronary arteries?

Population

31 patients with chest pain, an ischemic-appearing exercise electrocardiogram, and angiographically normal coronary arteries

Intervention

First-pass radionuclide angiocardiography at rest and during maximal upright bicycle exercise, Thallium-201 imaging after treadmill exercise, and ergonovine provocation in selected patients

Outcome

Left ventricular performance (ejection fraction response and regional dysfunction) during exercisesurrogate

A substantial number of patients with chest pain, ischemic exercise ECGs, and normal coronary arteries exhibit left ventricular dysfunction during exercise despite normal resting performance.

Cite This Study

Harvey J. Berger (1981) studied this question.

synapsesocial.com/papers/6a7dbbaf6bb6a3a5bcac7cb5 https://doi.org/10.7326/0003-4819-94-2-186

Topics

Coronary CT angiography

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Exercise Left Ventricular Performance in Patients with Chest Pain, Ischemic-Appearing Exercise Electrocardiograms, and Angiographically Normal Coronary Arteries

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Exercise Left Ventricular Performance in Patients with Chest Pain, Ischemic-Appearing Exercise Electrocardiograms, and Angiographically Normal Coronary Arteries

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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