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Related Experiment Videos

Adenosine provokes diastolic dysfunction in microvascular angina.

D Vinereanu1, A G Fraser, M Robinson

  • 1Department of Cardiology, University Hospital of Wales, Cardiff, UK.

Postgraduate Medical Journal
|January 18, 2002
PubMed
Summary

Adenosine stress echocardiography revealed diastolic dysfunction in patients with microvascular angina. This dysfunction, particularly long axis diastolic dysfunction, was easily detected using tissue Doppler of the lateral mitral annulus.

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Area of Science:

  • Cardiology
  • Cardiovascular Physiology
  • Diagnostic Imaging

Background:

  • Microvascular angina is characterized by chest pain despite normal coronary arteries.
  • Assessing cardiac function during stress is crucial for diagnosing and managing angina.
  • Diastolic dysfunction can be an early indicator of cardiac compromise.

Purpose of the Study:

  • To investigate the effects of adenosine stress on global and regional ventricular function in patients with microvascular angina.
  • To determine if adenosine stress induces diastolic dysfunction.
  • To evaluate the utility of tissue Doppler echocardiography in detecting stress-induced diastolic dysfunction.

Main Methods:

  • Adenosine stress echocardiography was performed in nine patients with microvascular angina.

Related Experiment Videos

  • Global ventricular function was assessed using Tc(99m) blood pool imaging and Doppler.
  • Longitudinal ventricular function was assessed using simultaneous tissue Doppler echocardiography of the lateral mitral annulus.

    • Main Results:

    • Adenosine infusion did not significantly alter global or longitudinal systolic function.
    • Adenosine induced global diastolic dysfunction, evident on blood pool imaging and transmitral flow Doppler.
    • All patients exhibited long axis diastolic dysfunction at peak adenosine, indicated by a specific mitral annular velocity ratio.

    Conclusions:

    • Adenosine stress provokes regional and global diastolic dysfunction in microvascular angina.
    • Subendocardial ischemia may underlie the observed diastolic dysfunction.
    • Tissue Doppler of the lateral annular motion is a sensitive method for detecting long axis diastolic dysfunction.