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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Significant coronary artery disease detected by amyl nitrite and systolic time intervals

H Mitake, T Sawayama, S Nezuo

    The American Journal of Cardiology
    |July 1, 1984
    PubMed

    Insights

    Amyl nitrite (AN) inhalation effectively differentiates coronary artery disease (CAD) severity by analyzing left ventricular systolic time intervals. A significant change in the ejection time/preejection period ratio indicates normal coronary arteries, aiding in CAD diagnosis.

    Area of Science:

    • Cardiology
    • Diagnostic Medicine
    • Physiology

    Background:

    • Coronary artery disease (CAD) diagnosis relies on invasive procedures.
    • Non-invasive methods for assessing CAD severity are crucial.
    • Systolic time intervals reflect left ventricular function.

    Purpose of the Study:

    • To evaluate the relationship between amyl nitrite (AN)-induced changes in left ventricular systolic time intervals and CAD severity.
    • To determine the diagnostic utility of the AN inhalation test for detecting significant CAD.

    Main Methods:

    • Seventy-seven patients undergoing cardiac catheterization were studied.
    • Left ventricular systolic time intervals, including ejection time (ET) and preejection period (PEP), were measured before and after AN inhalation.
    • Changes in ET/PEP ratio and left ventricular dP/dt were analyzed in relation to CAD presence and severity.

    Main Results:

    • In control subjects, AN inhalation significantly increased ET and the ET/PEP ratio.
    • Patients with CAD showed insignificant changes in ET/PEP after AN inhalation.
    • A less than 30% increase in ET/PEP with AN inhalation detected significant CAD with 92% sensitivity and 84% specificity.

    Conclusions:

    • Amyl nitrite inhalation significantly alters systolic time intervals in healthy individuals but not in patients with CAD.
    • The AN inhalation test is a safe, simple, and effective stress test for evaluating the presence and severity of significant CAD.
    • The degree of CAD influences the response to AN, suggesting factors beyond pump function are involved.

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