Symptom-limited arm exercise increases detection of ischemia during dipyridamole tomographic thallium stress testing in patients with coronary artery disease
| Autor: | Leon Stein, Naomi S. Fineberg, Donald S. Schauwecker, Robert W. Burt, Bernard E. Oppenheim |
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| Rok vydání: | 1995 |
| Předmět: |
Male
medicine.medical_specialty Ischemia chemistry.chemical_element Physical exercise Coronary Disease Chest pain Scintigraphy Angina Coronary artery disease Internal medicine Medicine Humans cardiovascular diseases Prospective Studies Radionuclide Imaging Aged medicine.diagnostic_test business.industry Confounding Factors Epidemiologic Dipyridamole Middle Aged medicine.disease Thallium Radioisotopes chemistry cardiovascular system Cardiology Arm Exercise Test Thallium Female Radiology medicine.symptom Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | The American journal of cardiology. 75(8) |
| ISSN: | 0002-9149 |
| Popis: | Exercise combined with dipyridamole during thallium stress testing in patients with coronary artery disease (CAD) increases the frequency of angina and ischemic ST changes in the electrocardiogram. Evidence for an increase in thallium abnormalities has been inconclusive. We prospectively examined 54 consecutive patients who underwent coronary angiography and tomographic thallium with dipyridamole (0.57 mg/kg) alone and combined with symptom-limited dynamic arm exercise. Most patients presented with a history of chest pain and 49 had angiographic evidence of significant coronary stenosis (50% diameter narrowing). Thallium abnormalities were scored blindly by consensus. The number of abnormal segments (total and ischemic) and indexes of left ventricular dysfunction, such as increased lung uptake or ischemic dilation, were compared in the 49 patients with CAD. During arm exercise more patients had evidence of ischemia (39 vs 30; p0.001), and the number of ischemic segments increased significantly from 1.3 +/- 1.5 to 2.5 +/- 2.2 (p0.001). There was also a significant increase in the indexes of left ventricular dysfunction, ischemic dilation (10 vs 4 patients; p0.03) and increased lung uptake (16 vs 5 patients; p0.001). Patients who exercised had increased thallium evidence of extent and severity of ischemia and more frequent indexes of left ventricular dysfunction. Thus, symptom-limited arm exercise improves detection of extent and severity of ischemia in patients with CAD undergoing dipyridamole thallium stress testing. |
| Databáze: | OpenAIRE |
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