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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Screening cerebrovascular patients for silent myocardial ischemia with stress testing and ambulatory left ventricular

D H Jacobs1, S L Lawhorn2, D K Ziegler1

  • 1From the Department of Neurology, University of Kansas School of Medicine, Kansas City, KS, U.S.A.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|October 22, 2015
PubMed

Insights

Silent myocardial ischemia is a risk for cerebrovascular patients. Ambulatory ventricular function monitoring (VEST) shows promise for detecting this, alongside standard exercise electrocardiography (EKG).

Area of Science:

  • Cardiology
  • Neurology
  • Diagnostic Imaging

Background:

  • Symptomatic cerebrovascular disease patients face high mortality from myocardial ischemia.
  • Myocardial ischemia can occur at rest or post-exercise in these patients.

Purpose of the Study:

  • To evaluate the utility of ambulatory left ventricular function monitoring (VEST) combined with electrocardiography (EKG) for detecting silent myocardial ischemia in patients with cerebrovascular disease.

Main Methods:

  • A pilot study involving 11 patients with transient cerebral ischemic attack or stroke.
  • Utilized bicycle ergometer stress testing with EKG monitoring.
  • Employed ambulatory left ventricular function monitoring (VEST) during and after exercise.

Main Results:

  • Three of 11 patients had nondiagnostic EKGs but positive VEST results.
  • One patient showed a false-positive VEST result.
  • VEST demonstrated potential in identifying silent ischemia when EKG was inconclusive.

Conclusions:

  • VEST may aid in detecting silent myocardial ischemia in cerebrovascular patients, especially when combined with stress EKG.
  • Further studies are needed to confirm VEST's sensitivity and specificity in this population.

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