Normal coronary flow reserve in patients with mitral valve prolapse, a positive exercise test and normal coronary arteries
| Autor: | S. Karas, P.K. Toutouzas, John Gialafos, Michael Kyriakidis, Filippos Triposkiadis, Costas Tentolouris, Panaghiotis Petropoulakis |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Adult
Male Chest Pain medicine.medical_specialty medicine.medical_treatment Coronary Disease Coronary Angiography Chest pain Diagnosis Differential Coronary artery disease Electrocardiography Coronary Circulation Internal medicine medicine.artery Mitral valve medicine Humans Mitral valve prolapse cardiovascular diseases Cardiac catheterization Mitral Valve Prolapse business.industry Coronary flow reserve Middle Aged medicine.disease Echocardiography Doppler Surgery Coronary arteries medicine.anatomical_structure Echocardiography Right coronary artery Exercise Test Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Blood Flow Velocity |
| Zdroj: | European Heart Journal. 16:1960-1967 |
| ISSN: | 1522-9645 0195-668X |
| DOI: | 10.1093/oxfordjournals.eurheartj.a060854 |
| Popis: | We studied 12 patients (eight females and four males), ages 30-46 years, with echocardiographically documented mitral valve prolapse and clinical suspicion of coronary artery disease, based on a history of chest pain (five patients), angina-like pain (three patients), a positive exercise stress electrocardiogram (12 patients) and a focally positive thallium-201 stress perfusion scan (three patients), who were referred for cardiac catheterization and found to have normal coronary arteries. Ten patients without evidence of heart disease served as controls. In all mitral valve prolapse patients, coronary flow velocity reserve was determined successively in the left anterior descending, left circumflex and right coronary arteries as the ratio of the maximum (after intracoronary papaverine) to the resting mean coronary flow velocity. Coronary flow reserve values were fairly similar in the mitral valve prolapse and control patients; all 12 mitral valve prolapse patients had normal coronary flow reserve ( > or = 3.5) in all three coronary arteries with no significant differences among the arteries tested. Mean values +/- 1 standard deviation of the coronary flow reserve (mitral valve prolapse vs control patients) were 4.7 +/- 0.5 vs 4.6 +/- 0.6 for the left anterior descending, 4.6 +/- 0.4 vs 4.6 +/- 0.3 for the left circumflex and 4.5 +/- 0.4 vs 4.4 +/- 0.5 for the right coronary artery (all P = non-significant). The subsets of mitral valve prolapse patients with different clinical "ischaemic' manifestations were similar in terms of the calculated coronary flow reserve in all three major epicardial coronary arteries. In conclusion, this study demonstrated that an inadequate regional coronary flow reserve does not account for the clinical manifestations of myocardial ischaemia and positive exercise tests in patients with mitral valve prolapse and normal coronary arteries. |
| Databáze: | OpenAIRE |
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