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Titolo:
RELATION BETWEEN EXERCISE-INDUCED MYOCARDIAL-ISCHEMIA AS ASSESSED BY N-13 AMMONIA POSITRON-EMISSION-TOMOGRAPHY AND QT INTERVAL BEHAVIOR IN PATIENTS WITH RIGHT BUNDLE-BRANCH BLOCK
Autore:
WATANABE T; HARUMI K; AKUTSU Y; YAMANAKA H; MICHIHATA T; OKAZAKI O; KATAGIRI T;
Indirizzi:
UNIV TEXAS,SCH MED,DEPT INTERNAL MED,DIV CARDIOL,6431 FANNIN,MSB 6-039 HOUSTON TX 77030 SHOWA UNIV,SCH MED,DEPT INTERNAL MED 3 TOKYO 142 JAPAN SHOWA UNIV,FUJIGAOKA HOSP,DIV CARDIOL YOKOHAMA KANAGAWA 227 JAPAN SHOWA UNIV,SCH MED,DEPT SURG 1 TOKYO 142 JAPAN UNIV UTAH,NORA ECCLES HARRISON CARDIOVASC RES & TRAINING IN SALT LAKECITY UT 00000
Titolo Testata:
The American journal of cardiology
fascicolo: 7, volume: 81, anno: 1998,
pagine: 816 - 821
SICI:
0002-9149(1998)81:7<816:RBEMAA>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; N-13 AMMONIA; BLOOD-FLOW; HEART-DISEASE; ST DEPRESSION; ELECTROCARDIOGRAPHY; ACCURACY; SUPINE; REST; MEN;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
30
Recensione:
Indirizzi per estratti:
Citazione:
T. Watanabe et al., "RELATION BETWEEN EXERCISE-INDUCED MYOCARDIAL-ISCHEMIA AS ASSESSED BY N-13 AMMONIA POSITRON-EMISSION-TOMOGRAPHY AND QT INTERVAL BEHAVIOR IN PATIENTS WITH RIGHT BUNDLE-BRANCH BLOCK", The American journal of cardiology, 81(7), 1998, pp. 816-821

Abstract

Exercise-induced myocardial ischemia is difficult to detect with ST-Tchanges in patients with right bundle branch block (RBBB). We sought to predict exercise-induced myocardial ischemia with QT interval behavior during exercise in patients with RBBB. Twenty-two patients with angiographically proven coronary artery disease and RBBB and 9 healthy volunteers underwent nitrogen-13 ammonia positron emission tomography with bicycle ergometer exercise at a fixed workload of 25 W. Regional myocardial blood flow (RMBF) and electrocardiographic changes were measured both at rest and after 5 minutes of exercise. The QT interval wasmeasured from the onset of the QRS complex to the offset of the T wave in lead V-5. The Delta QT and Delta RMBF, which indicated values after 5 minutes of exercise minus values at rest, were negatively correlated (r = -0.74, p <0.001). Exercise-induced shortening of the QT interval (422 +/- 27 to 381 +/- 38 ms, p = 0.0020) was observed in 15 patients (group 1) and no change or prolongation (411 +/- 45 to 420 +/- 37 ms, p = NS) was observed in 7 patients (group 2). Multivessel disease was significantly more frequent but collateral circulation was significantly less in group 2 than in group 1 (p <0.01, p <0.05, respectively). Cardiac output at rest was significantly lower in groups 1 and 2 than in healthy volunteers (4.52 +/- 0.83 and 4.51 +/- 0.84 vs 6.20 +/- 0.83 L/min; p = 0.0014, p = 0.0003). Although RMBF at rest did not differ significantly among groups 1 and 2 and healthy volunteers (0.63 +/- 0.20 vs 0.69 +/- 0.13 and vs 0.77 +/- 0.14 ml/min/g), RMBF after 5 minutes of exercise was significantly lower in group 2 than in group 1 and healthy volunteers (0.78 +/- 0.11 vs 0.96 +/- 0.20 and vs 1.20 +/-0.18 ml/min/g; p = 0.0289, p <0.0001). The number of regions of critical coronary artery disease was significantly greater in group 2 than in group 1 (4.0 +/- 1.2 vs 2.1 +/- 1.3, p = 0.0039). Our results suggest that the absence of QT interval shortening during exercise may indicate severe myocardial ischemia induced by exercise in patients with RBBB and coronary artery disease. (C) 1998 by Excerpta Medica, Inc.

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Documento generato il 19/01/20 alle ore 09:01:09