Exercise radionuclide ventriculographic responses in hypertensive patients with chest pain

Journal Article · Thu Nov 15 04:00:00 EST 1984 · N.Engl. J. Med.; (United States)

DOI:https://doi.org/10.1056/NEJM198411153112003· OSTI ID:6057076

Wasserman, A G; Katz, R J; Varghese, P J; Leiboff, R H; Bren, G G; Schlesselman, S; Varma, V M; Reba, R C; Ross, A M

The effectiveness of exercise-treadmill testing in diagnosing coronary-artery disease in hypertensive patients is limited by a high rate of false positivity. Exercise radionuclide ventriculography, however, relies on different criteria (ejection fraction and wall motion), and we have evaluated this procedure in 37 hypertensive and 109 normotensive patients with chest pain, using coronary arteriography as an indicator of coronary disease. In the hypertensive cohort there was no difference in the ejection fraction at rest between the 17 patients with coronary disease and the 20 without it. Neither group had a significant mean (+/- S.E.M.) change in ejection fraction from rest to exercise (-1.9 +/- 2 and 1.4 +/- 1%, respectively). A wall-motion abnormality developed during exercise in 5 of the 17 hypertensive patients with coronary disease (29%) and in 4 of the 20 without it (20%) (P = not significant). In the normotensive cohort, however, the peak-exercise ejection fractions were significantly different. The 71 patients with coronary disease had a mean decrease of 3.6 +/- 1%, in contrast to the patients without coronary disease, who had an increase of +/- 1% (P < 0.001). An exercise-induced wall-motion abnormality was seen in 35 of the 71 patients with coronary disease (48%), as compared with 3 of the 38 without it (8%) (P < 0.001). We conclude that exercise radionuclide ventriculography is inadequate as a screening test for coronary atherosclerosis in hypertensive patients with chest pain. 28 references, 2 figures, 3 tables.

• Research Organization: George Washington Univ. Medical Center, Washington, DC
• OSTI ID: 6057076
• Journal Information: N.Engl. J. Med.; (United States), Journal Name: N.Engl. J. Med.; (United States) Vol. 311:20; ISSN NEJMA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
BIOMEDICAL RADIOGRAPHY
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CORONARIES
COUNTING TECHNIQUES
DATA
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
EXERCISE
EXPERIMENTAL DATA
HEART
INFORMATION
ISOTOPES
MEDICINE
NUCLEAR MEDICINE
NUMERICAL DATA
ORGANS
PAIN
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOLOGY
SYMPTOMS