Related Experiment Video
Updated: Jul 3, 2026
Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test
Published on: April 27, 2016
Absence of myocardial dysfunction during cold pressor stress echocardiography in patients with endothelial
Tomás F Cianciulli1, Jorge A Lax, Osvaldo H Masoli
1Division of Cardiology, Hospital del Gobierno de la Ciudad de Buenos Aires Dr. Cosme Argerich, Buenos Aires, Argentina. tcianciulli@fibertel.com.ar
Insights
Cold pressor stress echocardiography (CPSE) did not reveal changes in left ventricular function during ischemia in patients with endothelial dysfunction. This suggests that ischemia secondary to endothelial dysfunction does not involve enough heart muscle to impair function.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Diagnostic Techniques
Background:
- Assessing coronary endothelial function is crucial, yet the utility of cold pressor stress echocardiography (CPSE) remains unexplored.
- Existing methods for evaluating endothelial function lack comprehensive assessment during stress.
Purpose of the Study:
- To evaluate regional systolic and diastolic left ventricular (LV) function using CPSE in patients with endothelial dysfunction.
- To determine if CPSE can detect functional changes in the LV during induced ischemia.
Main Methods:
- 24 patients with coronary risk factors and normal exercise MP-SPECT underwent CPSE, compared to 10 healthy controls.
- Patients were assessed for myocardial ischemia using cold pressor-MP-SPECT and CPSE, including 2D echo and pulsed Doppler tissue imaging.
Main Results:
- Cold pressor-MP-SPECT identified myocardial ischemia in 10 patients; all controls and 14 patients had normal results.
- The cold pressor test significantly increased systolic blood pressure without altering heart rate or intervals.
- No patient exhibited wall motion abnormalities (WMA) or changes in regional systolic/diastolic LV function during CPSE.
Conclusions:
- In patients with endothelial dysfunction and no coronary artery disease, CPSE does not reveal WMA or functional LV changes during ischemic responses.
- These findings imply that ischemia from endothelial dysfunction may not involve sufficient myocardial mass to cause contractile impairment.
- CPSE appears to be a safe method for assessing LV function under stress in this patient group.
Background:
Several methods are available for the assessment of coronary endothelial function, but there are no reports to date regarding the usefulness of cold pressor stress echocardiography (CPSE).
Objective:
To assess regional systolic and diastolic left ventricular function using CPSE in patients with endothelial dysfunction.
Methods:
We studied 24 patients, of whom 10 were men, aged 27 to 68 years, who had coronary risk factors and a normal exercise MP-SPECT test. They were compared with 10 normal subjects (6 men), aged 21 to 44 years. All patients underwent a CPSE.
Results:
The cold pressor-MP-SPECT revealed myocardial ischemia in 10 patients (Group I) and was normal in 14 patients (Group II). All normal subjects (Group III) had normal cold pressor-MP-SPECT. The cold pressor test caused a significant increase in systolic BP in the three groups (baseline 117 +/- 17 mmHg vs. postcold test 137 +/- 16 mmHg, P < 0.05), without changes in heart rate, PR interval, or the corrected QT interval. During the CPSE, no patient developed WMA in 2D echo or changes in regional systolic or diastolic LV function in the pulsed Doppler tissue imaging.
Conclusions:
In patients with endothelial dysfunction and no known coronary artery disease, the ischemic response to the cold pressor-MP-SPECT is not accompanied by WMA or changes in regional systolic or diastolic LV function during CPSE. Such negative findings indicate that the amount of ischemia that occurs secondarily to endothelial dysfunction does not involve sufficient myocardial mass to cause contractile dysfunction.
Related Concept Videos
01:26Exercise Stress Test
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion, evaluates...