The cold pressor test during radionuclide ventriculography: a feasibility study in cancer patients

To monitor the use of cardiotoxic drugs, adequate assessment of myocardial function is required. Although serial radionuclide left ventricular ejection fraction (EF) studies allow a simple and rapid assessment of the myocardial function without risk or discomfort to the patient, they appear not to be sensitive enough. Determination of the EF during cold application may be more sensitive. In this study we tested the feasibility of the cold pressor test (CPT) in relation to EF determination in 23 cancer patients. Only minor side effects were recorded. The response of heart rate to cold was similar to the response reported in healthy volunteers and patients with coronary artery disease. In selected cases EF determination during CPT appeared to be more sensitive than EF at rest. EFCPT may be an attractive alternative for EFexercise in cancer patients who cannot perform enough exercise to stress cardiac function adequately, but for a more definite conclusion a prospective comparative study is required.