Determination of the optimal timing for performing digital ventriculography during atrial pacing stress tests in coronary heart disease
| Autor: | Jonathan M. Tobis, Orhan Nalcioglu, Jim Paynter, Carol de Boer, Warren D. Johnston, Anil Shah, Walter L. Henry, Lloyd T. Iseri |
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| Rok vydání: | 1985 |
| Předmět: |
Adult
Male Coronary angiography medicine.medical_specialty Heart Ventricles Coronary Disease Coronary Angiography Coronary artery disease Electrocardiography Heart Rate Internal medicine Humans Medicine cardiovascular diseases Aged Ejection fraction Atrial pacing business.industry Angiography Cardiac Pacing Artificial Subtraction Stroke Volume Middle Aged medicine.disease Time optimal Coronary heart disease Coronary arteries medicine.anatomical_structure Subtraction Technique Exercise Test Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Tobis, J; Iseri, L; Johnston, WD; Nalcioglu, O; de Boer, C; Shah, A; et al.(1985). Determination of the optimal timing for performing digital ventriculography during atrial pacing stress tests in coronary heart disease. The American Journal of Cardiology, 56(7), 426-433. doi: 10.1016/0002-9149(85)90880-X. UC Irvine: Retrieved from: http://www.escholarship.org/uc/item/5vn6w99z |
| ISSN: | 0002-9149 |
| Popis: | To determine the optimal time for recording left ventricular angiograms during atrial pacing stress tests, digital subtraction left ventriculograms were obtained using 12 ml of contrast material in 40 patients at rest and at peak pacing. Nineteen of the 40 patients had a third digital left ventriculogram performed between 5 and 10 seconds and 21 patients had a third digital left ventriculogram performed 30 seconds after pacing was stopped. Coronary angiography showed significant coronary artery disease (CAD) in 29 patients and no evidence of significant CAD in 11 patients. Ejection fraction (EF) increased or did not change at peak pacing in 10 of 11 patients without CAD. In the 29 patients with CAD, mean EF decreased an average of 10 percentage points (p < 0.001) and fell 2 or more percentage points in 25 patients (86%) at peak pacing. These changes in EF were accompanied by the development of wall motion abnormalities, which occurred in segments of myocardium that were supplied by coronary arteries with angiographic CAD (more than 50% diameter narrowing). In contrast, the mean EF during the postpacing studies decreased only 2.2 percentage points (difference not significant) over rest values. Moreover, 15 to 29 patients (52%) with CAD had a decrease in EF of 2 or more percentage points. Therefore, the sensitivity of the atrial pacing stress test was diminished when the analysis was performed at 10 or 30 seconds after pacing. It is concluded that EF changes and wall motion abnormalities induced by atrial pacing are of short duration. As a result, the optimal time for performing left ventricular analysis of EF and wall motion during atrial pacing is apparently at the peak heart rate and not 10 to 30 seconds after pacing is stopped. © 1985. |
| Databáze: | OpenAIRE |
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