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Titolo:
SEGMENTAL WALL-MOTION ABNORMALITIES ALTER VULNERABILITY TO VENTRICULAR ECTOPIC BEATS ASSOCIATED WITH ACUTE INCREASES IN AORTIC PRESSURE IN PATIENTS WITH UNDERLYING CORONARY-ARTERY DISEASE
Autore:
SIOGAS K; PAPPAS S; GRAEKAS G; GOUDEVENOS J; LIAPI G; SIDERIS DA;
Indirizzi:
UNIV IOANNINA,GEN HOSP,DEPT CARDIOL,DIV INTERNAL MED,LEOFOROS PANEPISTIMIOU IOANNINA 45500 GREECE
Titolo Testata:
HEART
fascicolo: 3, volume: 79, anno: 1998,
pagine: 268 - 273
SICI:
1355-6037(1998)79:3<268:SWAAVT>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONTRACTION-EXCITATION FEEDBACK; CONGESTIVE HEART-FAILURE; MYOCARDIAL-INFARCTION PERIOD; SUDDEN CARDIAC DEATH; HIGH BLOOD-PRESSURE; MECHANOELECTRICAL FEEDBACK; BALLOON VALVULOPLASTY; ANATOMIC CORRELATION; REENTRANT CIRCUITS; ACTION-POTENTIALS;
Keywords:
MECHANOELECTRICAL FEEDBACK; SEGMENTAL WALL MOTION; AKINESIA; DYSKINESIA; VENTRICULAR ECTOPIC BEATS; ARRHYTHMIAS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
58
Recensione:
Indirizzi per estratti:
Citazione:
K. Siogas et al., "SEGMENTAL WALL-MOTION ABNORMALITIES ALTER VULNERABILITY TO VENTRICULAR ECTOPIC BEATS ASSOCIATED WITH ACUTE INCREASES IN AORTIC PRESSURE IN PATIENTS WITH UNDERLYING CORONARY-ARTERY DISEASE", HEART, 79(3), 1998, pp. 268-273

Abstract

Objective-To evaluate whether patients with coronary artery disease are susceptible to pressure related ventricular arrhythmias, and if so to identify possible risk factors. Design-Interventional study. Methods-Metaraminol was given to 43 patients undergoing coronary arteriography for ischaemic heart disease to increase their aortic pressure, provided their systolic blood pressure was < 160 mm Hg and they mere in sinus rhythm, without any ventricular ectopic activity (or with fewer than six ventricular ectopic beats a minute) during a five minute control period. Results-During the metaraminol infusion, systolic aortic pressure rose from 131 (15) to 199 (12) mm Hg (mean (SD)). Ventricular ectopy appeared (or ventricular ectopic beats increased by > 100%) in 13/43 patients. Ventricular ectopy was not related to age, sex, presenceof hypertension, history of myocardial infarction, use of beta blockers, positive exercise test, number of vessels diseased, or heart rate change during metaraminol infusion. There was a strong relation between the appearance of ventricular arrhythmia and segmental wall motion abnormalities: 1/19 (5.3%, 95% confidence interval 0.1% to 26.0%) without abnormality; 2/12 (16.7%, 2.1% to 48.4%) with hypokinesia; and 10/12 (83.3%, 51.6% to 97.1%) with akinesia or dyskinesia, chi(2) = 22.7, p < 0.001). Ejection fraction was also a significant but not independent risk factor. Conclusions-Patients with segmental wall motion abnormalities are predisposed to ventricular ectopic beats during an increase in systolic aortic pressure. This could be explained by associated electrophysiological inhomogeneity. The presence of mechanical inhomogeneity, as may occur in postinfarction akinesia or dyskinesia, may affect the aortic pressure above which ventricular arrhythmias appear.

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Documento generato il 24/11/20 alle ore 11:21:12