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Titolo:
EXERCISE-INDUCED ST-SEGMENT CHANGES PERMIT PREDICTION OF IMPROVEMENT IN LEFT-VENTRICULAR ISCHEMIC DYSFUNCTION AFTER REVASCULARIZATION - EVALUATION WITH POSITRON EMISSION TOMOGRAPHIC MEASUREMENTS OF REGIONAL MYOCARDIAL BLOOD-FLOW AND CARDIAC-OUTPUT
Autore:
WATANABE T; HARUMI K; MICHIHATA T; OKAZAKI O; YAMANAKA H; AKUTSU Y; 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 84112
Titolo Testata:
Journal of nuclear cardiology
fascicolo: 3, volume: 5, anno: 1998,
pagine: 256 - 264
SICI:
1071-3581(1998)5:3<256:ESCPPO>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; AMERICAN-HEART-ASSOCIATION; WALL-MOTION ABNORMALITIES; N-13 AMMONIA; DOBUTAMINE ECHOCARDIOGRAPHY; F-18 FLUORODEOXYGLUCOSE; COMPUTED-TOMOGRAPHY; VIABLE MYOCARDIUM; INFARCTION; SCINTIGRAPHY;
Keywords:
EXERCISE-INDUCED ST-SEGMENT CHANGES; LOW-LEVEL EXERCISE; REGIONAL MYOCARDIAL BLOOD FLOW; CARDIAC OUTPUT; POSITRON EMISSION TOMOGRAPHY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
45
Recensione:
Indirizzi per estratti:
Citazione:
T. Watanabe et al., "EXERCISE-INDUCED ST-SEGMENT CHANGES PERMIT PREDICTION OF IMPROVEMENT IN LEFT-VENTRICULAR ISCHEMIC DYSFUNCTION AFTER REVASCULARIZATION - EVALUATION WITH POSITRON EMISSION TOMOGRAPHIC MEASUREMENTS OF REGIONAL MYOCARDIAL BLOOD-FLOW AND CARDIAC-OUTPUT", Journal of nuclear cardiology, 5(3), 1998, pp. 256-264

Abstract

Background. Prediction of the recovery of left ventricular (LV) ischemic dysfunction after revascularization is important in patients with coronary artery disease (CAD). We investigated whether the improvementin LV ischemic dysfunction after revascularization could be predictedpreoperatively by exercise-induced ST-segment changes. Methods and Results. Regional myocardial blood flow (RMBF) and cardiac output were measured with nitrogen 13-ammonia positron emission tomography at rest and during low-level exercise in 28 patients with angiographically proven CAD before and after successful revascularization and in 9 normal subjects. Before revascularization, exercise-induced upsloping ST-segment depression < 1 mm 80 msec after the J-point was observed in 11 patients (group 1), horizontal depression of 1 to 1.5 mm was observed in 9 patients (group 2), and downsloping depression greater than or equalto 1.5 mm was observed in 8 patients (group 3), The number of regionsof critical CAD was greater in group 3 than in groups 1 and 2 (3.6 +/- 1.4 vs 1.6 +/- 0.7 and 2.2 +/- 1.1, p < 0.001, p < 0.02). Increase of RMBF in regions of critical CAD with exercise was lower in group 3 than in groups 1 and 2 (0.15 +/- 0.01 vs 0.22 +/- 0.01 and 0.18 +/- 0.02 ml/min per gram, p < 0.0001, p < 0.01). After revascularization, RMBF in regions of critical CAD both at rest and during exercise improvedin groups 1 (0.49 +/- 0.15 to 0.60 +/- 0.18, 0.70 +/- 0.26 to 0.86 +/- 0.33 ml/min per gram, both p < 0.05) and 2 (0.50 +/- 0.15 to 0.62 +/- 0.19, 0.67 +/- 0.26 to 0.89 +/- 0.31 ml/min per gram, both p < 0.02), but was unchanged in group 3 (0.47 +/- 0.09 to 0.47 +/- 0.15, 0.62 +/- 0.17 to 0.64 +/- 0.23 ml/min per gram, both p = NS). Cardiac outputat rest improved in groups 1 (4.98 +/- 0.43 to 5.35 +/- 0.50 L/min, p< 0.02) and 2 (5.08 +/- 0.52 to 5.53 +/- 0.28 L/min,p < 0.02), but was unchanged in group 3 (4.76 +/- 0.48 to 4.88 +/- 0.82 L/min, p = NS). Conclusions. Our results suggest that marked downsloping ST-segment depression induced by preoperative low-level exercise may predict a lack of improvement in LV ischemic dysfunction after revascularization.

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Documento generato il 26/01/20 alle ore 01:19:13