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Correlation of cold pressor response with coronary atherosclerosis and left ventricular performance
Insights
The cold pressor response can help identify coronary artery disease. An exaggerated response suggests atherosclerosis, while impaired left ventricular function may normalize this response.
Area of Science:
- Cardiology
- Physiology
Background:
- Chest pain is a common symptom requiring accurate diagnosis of coronary heart disease.
- The cold pressor response (CPR) is a physiological test that may offer insights into cardiovascular health.
Purpose of the Study:
- To compare the cold pressor response with coronary arteriography and left ventriculography in patients with suspected coronary heart disease.
- To investigate the relationship between CPR, coronary atherosclerosis, and left ventricular function.
Main Methods:
- Twenty-six consecutive patients with chest pain suggestive of coronary heart disease underwent CPR, coronary arteriography, and left ventriculography.
- CPR was assessed in conjunction with the severity of coronary atherosclerosis and left ventricular performance.
Main Results:
- Normal coronary arteriograms and left ventriculograms correlated with normal CPR.
- An exaggerated CPR was observed in patients with coronary atherosclerosis and normal left ventricular performance.
- Severe coronary atherosclerosis and poor left ventricular performance, as well as anterior wall myocardial infarction with anterior wall dyskinesia/akinesia, blunted the exaggerated CPR.
- Inferior wall myocardial infarction with inferior wall dyskinesia/akinesia did not impair the CPR.
Conclusions:
- The cold pressor response is a valuable, non-invasive tool for assessing coronary artery disease severity and its impact on left ventricular function.
- CPR can differentiate between normal coronary arteries, atherosclerosis with preserved ventricular function, and impaired ventricular function due to myocardial infarction.
Abstract:
A comparison of cold pressor response with coronary arteriography and left ventriculography was made in 26 consecutive patients having chest pain suggesting coronary heart disease. Patients with normal coronary arteriograms and normal left ventriculograms showed normal cold pressor responses. Patients with coronary atherosclerosis and normal left ventricular performance showed an exaggerated cold pressor response, whereas patients with severe coronary atherosclerosis and poor left ventricular performance did not exhibit an exaggerated cold pressor response. In patients with inferior wall myocardial infarction having dyskinesia or akinesia of the inferior wall, the cold pressor response was not impaired. In contrast, patients with anterior wall myocardial infarction and dyskinesia or akinesia of the anterior wall showed a marked impairment of the left ventricular performance and no exaggeration of the cold pressor response.