Clinical significance of exercise-induced left ventricular wall motion abnormality occurring at a low heart rate

Journal Article · Thu Oct 01 00:00:00 EDT 1987 · Am. Heart J.; (United States)

DOI:https://doi.org/10.1016/0002-8703(87)90781-2· OSTI ID:5851205

Kimchi, A; Rozanski, A; Fletcher, C; Maddahi, J; Swan, H J; Berman, D S

We studied the relationship between the heart rate at the time of onset of exercise-induced wall motion abnormality and the severity of coronary artery disease in 89 patients who underwent exercise equilibrium radionuclide ventriculography as part of their evaluation for coronary artery disease. Segmental wall motion was scored with a five-point system (3 = normal; -1 = dyskinesis); a decrease of one score defined the onset of wall motion abnormality. The onset of wall motion abnormality at less than or equal to 70% of maximal predicted heart rate had 100% predictive accuracy for coronary artery disease and higher sensitivity than the onset of ischemic ST segment depression at similar heart rate during exercise: 36% (25 of 69 patients with coronary disease) vs 19% (13 of 69 patients), p = 0.01. Wall motion abnormality occurring at less than or equal to 70% of maximal predicted heart rate was present in 49% of patients (23 of 47) with critical stenosis (greater than or equal to 90% luminal diameter narrowing), and in only 5% of patients (2 of 42) without such severe stenosis, p less than 0.001. The sensitivity of exercise-induced wall motion abnormality occurring at a low heart rate for the presence of severe coronary artery disease was similar to that of a deterioration in wall motion by more than two scores during exercise (49% vs 53%) or an absolute decrease of greater than or equal to 5% in exercise left ventricular ejection fraction (49% vs 45%).

• Research Organization: Univ. of California, Los Angeles
• OSTI ID: 5851205
• Journal Information: Am. Heart J.; (United States), Vol. 114
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARDIOVASCULAR DISEASES
DIAGNOSIS
HEART
RADIOISOTOPE SCANNING
ERYTHROCYTES
EXERCISE
PATIENTS
TECHNETIUM
BIOLOGICAL MATERIALS
BLOOD
BLOOD CELLS
BODY
BODY FLUIDS
CARDIOVASCULAR SYSTEM
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550601* - Medicine- Unsealed Radionuclides in Diagnostics