Left ventricular pressure/volume relationship in coronary artery disease
This study examined the changes during exercise in LV EF and P V relationship (systolic blood pressure/end-systolic volume index ratio) in 287 patients. Normal range (mean ± standard deviation) for exercise EF, exercise P V , and the changes from rest to exercise (Δ) in EF and P V were established i...
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Published in | The American heart journal Vol. 112; no. 2; pp. 375 - 381 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
New York, NY
Mosby, Inc
01.08.1986
Elsevier |
Subjects | |
Online Access | Get full text |
ISSN | 0002-8703 1097-6744 |
DOI | 10.1016/0002-8703(86)90278-4 |
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Abstract | This study examined the changes during exercise in LV EF and
P
V
relationship (systolic blood pressure/end-systolic volume index ratio) in 287 patients. Normal range (mean ± standard deviation) for exercise EF, exercise
P
V
, and the changes from rest to exercise (Δ) in EF and
P
V
were established in 51 subjects with <1% probability of CAD. The results were compared to those obtained in 53 patients with normal coronary angiograms and 183 patients with angiographically proven CAD. Abnormality in either ΔEF or percent
ΔP
V
were observed in 76% of the patients with one-vessel disease and in 91% of patients with multivessel disease. Abnormalities in either ΔEF or percent
ΔP
V
were more common than ΔEF alone in the total CAD group and in subgroups stratified according to the resting EF, extent of CAD, and adequacy of exercise end points. Similar results were obtained when absolute exercise EF or exercise
P
V
were used. Abnormalities in the percent
ΔP
V
or ΔEF were also seen in 26 of the 53 patients with normal coronary angiograms. Thus, abnormalities in the
P
V
relationship or EF during exercise are more common than abnormalities in the EF alone. Relative and absolute measurements provide similar results. |
---|---|
AbstractList | This study examined the changes during exercise in LV EF and P/V relationship (systolic blood pressure/end-systolic volume index ratio) in 287 patients. Normal range (mean +/- standard deviation) for exercise EF, exercise P/V, and the changes from rest to exercise (delta) in EF and P/V were established in 51 subjects with less than 1% probability of CAD. The results were compared to those obtained in 53 patients with normal coronary angiograms and 183 patients with angiographically proven CAD. Abnormality in either delta EF or percent delta P/V were observed in 76% of the patients with one-vessel disease and in 91% of patients with multivessel disease. Abnormalities in either delta EF or percent delta P/V were more common than delta EF alone in the total CAD group and in subgroups stratified according to the resting EF, extent of CAD, and adequacy of exercise end points. Similar results were obtained when absolute exercise EF or exercise P/V were used. Abnormalities in the percent delta P/V or delta EF were also seen in 26 of the 53 patients with normal coronary angiograms. Thus, abnormalities in the P/V relationship or EF during exercise are more common than abnormalities in the EF alone. Relative and absolute measurements provide similar results.This study examined the changes during exercise in LV EF and P/V relationship (systolic blood pressure/end-systolic volume index ratio) in 287 patients. Normal range (mean +/- standard deviation) for exercise EF, exercise P/V, and the changes from rest to exercise (delta) in EF and P/V were established in 51 subjects with less than 1% probability of CAD. The results were compared to those obtained in 53 patients with normal coronary angiograms and 183 patients with angiographically proven CAD. Abnormality in either delta EF or percent delta P/V were observed in 76% of the patients with one-vessel disease and in 91% of patients with multivessel disease. Abnormalities in either delta EF or percent delta P/V were more common than delta EF alone in the total CAD group and in subgroups stratified according to the resting EF, extent of CAD, and adequacy of exercise end points. Similar results were obtained when absolute exercise EF or exercise P/V were used. Abnormalities in the percent delta P/V or delta EF were also seen in 26 of the 53 patients with normal coronary angiograms. Thus, abnormalities in the P/V relationship or EF during exercise are more common than abnormalities in the EF alone. Relative and absolute measurements provide similar results. This study examined the changes during exercise in LV EF and P V relationship (systolic blood pressure/end-systolic volume index ratio) in 287 patients. Normal range (mean ± standard deviation) for exercise EF, exercise P V , and the changes from rest to exercise (Δ) in EF and P V were established in 51 subjects with <1% probability of CAD. The results were compared to those obtained in 53 patients with normal coronary angiograms and 183 patients with angiographically proven CAD. Abnormality in either ΔEF or percent ΔP V were observed in 76% of the patients with one-vessel disease and in 91% of patients with multivessel disease. Abnormalities in either ΔEF or percent ΔP V were more common than ΔEF alone in the total CAD group and in subgroups stratified according to the resting EF, extent of CAD, and adequacy of exercise end points. Similar results were obtained when absolute exercise EF or exercise P V were used. Abnormalities in the percent ΔP V or ΔEF were also seen in 26 of the 53 patients with normal coronary angiograms. Thus, abnormalities in the P V relationship or EF during exercise are more common than abnormalities in the EF alone. Relative and absolute measurements provide similar results. This study examined the changes during exercise in LV EF and P/V relationship (systolic blood pressure/end-systolic volume index ratio) in 287 patients. Normal range (mean +/- standard deviation) for exercise EF, exercise P/V, and the changes from rest to exercise (delta) in EF and P/V were established in 51 subjects with less than 1% probability of CAD. The results were compared to those obtained in 53 patients with normal coronary angiograms and 183 patients with angiographically proven CAD. Abnormality in either delta EF or percent delta P/V were observed in 76% of the patients with one-vessel disease and in 91% of patients with multivessel disease. Abnormalities in either delta EF or percent delta P/V were more common than delta EF alone in the total CAD group and in subgroups stratified according to the resting EF, extent of CAD, and adequacy of exercise end points. Similar results were obtained when absolute exercise EF or exercise P/V were used. Abnormalities in the percent delta P/V or delta EF were also seen in 26 of the 53 patients with normal coronary angiograms. Thus, abnormalities in the P/V relationship or EF during exercise are more common than abnormalities in the EF alone. Relative and absolute measurements provide similar results. |
Author | Heo, Jaekyeong Iskandrian, Abdulmassih S. |
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Keywords | Heart Physical exercise Human Pressure volume ratio Cardiovascular disease Exercise tolerance test Hemodynamics Coronary heart disease Left ventricle |
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A combined radionuclide and hemodynamic study publication-title: Am J Cardiol – volume: 4 start-page: 1002 year: 1983 ident: BIB2 article-title: Value of left ventricular ejection fraction during exercise in predicting the extent of coronary artery disease publication-title: J Am Coll Cardiol – volume: 94 start-page: 186 year: 1981 ident: BIB27 article-title: Exercise left ventricular performance in patients with chest pain, ischemic appearing exercise electrocardiograms and angiographically normal coronary arteries publication-title: Ann Intern Med – volume: 60 start-page: 572 year: 1979 ident: BIB5 article-title: Sensitivity, specificity and predictive accuracy of radionuclide cineangiography during exercise in patients with coronary artery disease; comparison with exercise electrocardiography publication-title: Circulation – volume: 66 start-page: 638 year: 1982 ident: BIB23 article-title: Effect of exercise on erythrocyte count and blood activity concentration after technetium-99m in vivo red blood cell labeling publication-title: Circulation – volume: 52 start-page: 714 year: 1983 ident: BIB11 article-title: Non-invasive assessment of coronary artery disease publication-title: Am J Cardiol – volume: 63 start-page: 1008 year: 1981 ident: BIB14 article-title: Exercise-induced alterations in left ventricular volumes and the pressure/volume relationship: A sensitive indicator of left ventricular dysfunction in patients with coronary artery disease publication-title: Circulation – volume: 75 start-page: 771 year: 1983 ident: BIB20 article-title: Estimating the likelihood of significant coronary artery disease publication-title: Am J Med – volume: 40 start-page: 239 year: 1981 ident: BIB7 article-title: Quantitative radionuclide angiography in assessment of hemodynamic changes during upright exercise: Observations in normal subjects, patients with coronary artery disease and patients with aortic regurgitation publication-title: Am J Cardiol – volume: 60 start-page: 572 year: 1979 ident: 10.1016/0002-8703(86)90278-4_BIB5 article-title: Sensitivity, specificity and predictive accuracy of radionuclide cineangiography during exercise in patients with coronary artery disease; comparison with exercise electrocardiography publication-title: Circulation doi: 10.1161/01.CIR.60.3.572 – volume: 51 start-page: 43 year: 1983 ident: 10.1016/0002-8703(86)90278-4_BIB19 article-title: Radionuclide analysis of peak filling rate, filling fraction and time to peak filling rate: Response to supine bicycle exercise in normal subjects and patients with coronary artery disease publication-title: Am J Cardiol doi: 10.1016/S0002-9149(83)80009-5 – volume: 112 start-page: 75 year: 1986 ident: 10.1016/0002-8703(86)90278-4_BIB35 article-title: Age-related changes in left ventricular diastolic performance publication-title: Am Heart J doi: 10.1016/0002-8703(86)90681-2 – volume: 109 start-page: 1253 year: 1985 ident: 10.1016/0002-8703(86)90278-4_BIB3 article-title: The relation between myocardial ischemia and the ejection fraction response to exercise in patients with normal or abnormal resting left ventricular function publication-title: Am Heart J doi: 10.1016/0002-8703(85)90347-3 – volume: 58 start-page: 640 year: 1978 ident: 10.1016/0002-8703(86)90278-4_BIB17 article-title: Detection of coronary heart disease using radionuclide determined regional ejection fraction at rest and during handgrip exercise: Correlation with coronary arteriography publication-title: Circulation doi: 10.1161/01.CIR.58.4.640 – volume: 64 start-page: 586 year: 1981 ident: 10.1016/0002-8703(86)90278-4_BIB4 article-title: Accuracy of diagnosis of coronary artery disease by radionuclide measurement of left ventricular function during rest and exercise publication-title: Circulation doi: 10.1161/01.CIR.64.3.586 – volume: 301 start-page: 569 year: 1979 ident: 10.1016/0002-8703(86)90278-4_BIB15 article-title: Radionuclide determined change in pulmonary blood volume with exercise. Improved sensitivity of multigated blood pool scanning in detecting coronary artery disease publication-title: N Engl J Med doi: 10.1056/NEJM197909133011102 – volume: 82 start-page: 54 year: 1982 ident: 10.1016/0002-8703(86)90278-4_BIB16 article-title: Changes in pulmonary blood volume during upright exercise. Clinical implications publication-title: Chest doi: 10.1378/chest.82.1.54 – volume: 47 start-page: 7 year: 1971 ident: 10.1016/0002-8703(86)90278-4_BIB29 article-title: Left ventricular function in mitral valve prolapse: Assessment with radionuclide cineangiography publication-title: Am J Cardiol doi: 10.1016/0002-9149(81)90282-4 – volume: 40 start-page: 239 year: 1981 ident: 10.1016/0002-8703(86)90278-4_BIB7 article-title: Quantitative radionuclide angiography in assessment of hemodynamic changes during upright exercise: Observations in normal subjects, patients with coronary artery disease and patients with aortic regurgitation publication-title: Am J Cardiol doi: 10.1016/0002-9149(81)90602-0 – volume: 62 start-page: 341 year: 1980 ident: 10.1016/0002-8703(86)90278-4_BIB12 article-title: Influence of resting left ventricular function on the left ventricular response to exercise in patients with coronary artery disease publication-title: Circulation – volume: 110 start-page: 851 year: 1985 ident: 10.1016/0002-8703(86)90278-4_BIB9 article-title: Radionuclide evaluation of exercise left ventricular performance in patients with coronary artery disease publication-title: Am Heart J doi: 10.1016/0002-8703(85)90469-7 – volume: 64 start-page: 315 year: 1981 ident: 10.1016/0002-8703(86)90278-4_BIB18 article-title: Impaired left ventricular diastolic filling in patients with coronary artery disease: Assessment with radionuclide angiography publication-title: Circulation doi: 10.1161/01.CIR.64.2.315 – volume: 4 start-page: 1002 year: 1983 ident: 10.1016/0002-8703(86)90278-4_BIB2 article-title: Value of left ventricular ejection fraction during exercise in predicting the extent of coronary artery disease publication-title: J Am Coll Cardiol doi: 10.1016/S0735-1097(83)80101-6 – volume: 69 start-page: 1111 year: 1984 ident: 10.1016/0002-8703(86)90278-4_BIB28 article-title: The value of lesion cross-sectional area determined by quantitative coronary angiography in assessing the physiological significance of proximal left anterior descending coronary arterial stenosis publication-title: Circulation doi: 10.1161/01.CIR.69.6.1111 – volume: 311 start-page: 1276 year: 1984 ident: 10.1016/0002-8703(86)90278-4_BIB30 article-title: Exercise radionuclide ventriculographic responses in hypertensive patients with chest pain publication-title: N Engl J Med doi: 10.1056/NEJM198411153112003 – volume: 63 start-page: 1008 year: 1981 ident: 10.1016/0002-8703(86)90278-4_BIB14 article-title: Exercise-induced alterations in left ventricular volumes and the pressure/volume relationship: A sensitive indicator of left ventricular dysfunction in patients with coronary artery disease publication-title: Circulation doi: 10.1161/01.CIR.63.5.1008 – volume: 2 start-page: 21 year: 1983 ident: 10.1016/0002-8703(86)90278-4_BIB21 article-title: Hemodynamic, angiographic and scintigraphic correlates of positive exercise electrocardiograms: Emphasis on strongly positive exercise electrocardiograms publication-title: J Am Coll Cardiol doi: 10.1016/S0735-1097(83)80372-6 – volume: 94 start-page: 186 year: 1981 ident: 10.1016/0002-8703(86)90278-4_BIB27 article-title: Exercise left ventricular performance in patients with chest pain, ischemic appearing exercise electrocardiograms and angiographically normal coronary arteries publication-title: Ann Intern Med doi: 10.7326/0003-4819-94-2-186 – volume: 46 start-page: 813 year: 1980 ident: 10.1016/0002-8703(86)90278-4_BIB13 article-title: Peak systolic blood pressure, end-systolic volume ratio: Assessment at rest and during exercise in normal subjects and patients with coronary heart disease publication-title: Am J Cardiol doi: 10.1016/0002-9149(80)90433-6 – volume: 66 start-page: 643 year: 1982 ident: 10.1016/0002-8703(86)90278-4_BIB6 article-title: Ejection fraction response to exercise in patients with chest pain: Coronary artery disease and normal resting ventricular function publication-title: Circulation doi: 10.1161/01.CIR.66.3.643 – volume: 1 start-page: 1518 year: 1983 ident: 10.1016/0002-8703(86)90278-4_BIB1 article-title: Evaluation of left ventricular function by radionuclide angiography during exercise in normal subjects and in patients with chronic coronary artery disease publication-title: J Am Coll Cardiol doi: 10.1016/S0735-1097(83)80058-8 – volume: 52 start-page: 714 year: 1983 ident: 10.1016/0002-8703(86)90278-4_BIB11 article-title: Non-invasive assessment of coronary artery disease publication-title: Am J Cardiol doi: 10.1016/0002-9149(83)90404-6 – volume: 75 start-page: 771 year: 1983 ident: 10.1016/0002-8703(86)90278-4_BIB20 article-title: Estimating the likelihood of significant coronary artery disease publication-title: Am J Med doi: 10.1016/0002-9343(83)90406-0 – volume: 64 start-page: 952 year: 1981 ident: 10.1016/0002-8703(86)90278-4_BIB26 article-title: Ejection fraction response to exercise in patients with chest pain and normal coronary arteriograms publication-title: Circulation doi: 10.1161/01.CIR.64.5.952 – volume: 62 start-page: 528 year: 1980 ident: 10.1016/0002-8703(86)90278-4_BIB10 article-title: Left ventricular performance in normal subjects: A comparison of the responses to exercise in the upright and supine positions publication-title: Circulation doi: 10.1161/01.CIR.62.3.528 – volume: 187 start-page: 449 year: 1978 ident: 10.1016/0002-8703(86)90278-4_BIB8 article-title: Cardiac function at rest and during exercise in normals and in patients with coronary heart disease: Evaluation by radionuclide angiography publication-title: Ann Surg doi: 10.1097/00000658-197805000-00002 – volume: 71 start-page: 218 year: 1985 ident: 10.1016/0002-8703(86)90278-4_BIB32 article-title: Left ventricular dysfunction in patients with angina pectoris, normal epicardial coronary arteries, and abnormal vasodilator reserve publication-title: Circulation doi: 10.1161/01.CIR.71.2.218 – volume: 45 start-page: 293 year: 1980 ident: 10.1016/0002-8703(86)90278-4_BIB22 article-title: Nongeometric determination of left ventricular volumes from equilibrium blood pool scans publication-title: Am J Cardiol doi: 10.1016/0002-9149(80)90648-7 – volume: 54 start-page: 633 year: 1984 ident: 10.1016/0002-8703(86)90278-4_BIB31 article-title: Exercise-induced left ventricular dysfunction in young men with asymptomatic diabetes mellitus (diabetic cardiomyopathy) publication-title: Am J Cardiol doi: 10.1016/0002-9149(84)90263-7 – volume: 66 start-page: 638 year: 1982 ident: 10.1016/0002-8703(86)90278-4_BIB23 article-title: Effect of exercise on erythrocyte count and blood activity concentration after technetium-99m in vivo red blood cell labeling publication-title: Circulation doi: 10.1161/01.CIR.66.3.638 – volume: 51 start-page: 1057 year: 1983 ident: 10.1016/0002-8703(86)90278-4_BIB25 article-title: Left ventricular end-systolic pressure/volume relation. A combined radionuclide and hemodynamic study publication-title: Am J Cardiol doi: 10.1016/0002-9149(83)90344-2 – volume: 6 start-page: 1243 year: 1985 ident: 10.1016/0002-8703(86)90278-4_BIB33 article-title: Abnormal coronary flow reserve and abnormal radionuclide exercise test results in patients with normal coronary angiograms publication-title: J Am Coll Cardiol doi: 10.1016/S0735-1097(85)80209-6 – volume: 40 start-page: 748 year: 1977 ident: 10.1016/0002-8703(86)90278-4_BIB24 article-title: Pressure volume ratio: A new index of ventricular contractility publication-title: Am J Cardiol doi: 10.1016/0002-9149(77)90192-8 – volume: 53 start-page: 120 year: 1984 ident: 10.1016/0002-8703(86)90278-4_BIB34 article-title: Abnormal left ventricular filling: An early finding in mild to moderate systemic hypertension publication-title: Am J Cardiol doi: 10.1016/0002-9149(84)90695-7 |
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Snippet | This study examined the changes during exercise in LV EF and
P
V
relationship (systolic blood pressure/end-systolic volume index ratio) in 287 patients. Normal... This study examined the changes during exercise in LV EF and P/V relationship (systolic blood pressure/end-systolic volume index ratio) in 287 patients. Normal... |
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SubjectTerms | Adult Aged Biological and medical sciences Cardiology. Vascular system Coronary Disease - diagnostic imaging Coronary Disease - physiopathology Coronary heart disease Exercise Test Female Heart Heart - diagnostic imaging Heart Ventricles - physiopathology Humans Male Medical sciences Middle Aged Myocardial Contraction Physical Exertion Radionuclide Imaging Stroke Volume |
Title | Left ventricular pressure/volume relationship in coronary artery disease |
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