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Evaluation of Hydration Status by Bioelectrical Impedance Vector Analysis in Patients with Ischemic Heart Disease Undergoing Exercise Stress Test
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Exercise left ventricular performance in patients with chest pain, ischemic-appearing exercise electrocardiograms,

H J Berger, M J Sands, R A Davies

    Annals of Internal Medicine
    |February 1, 1981
    PubMed

    Insights

    Patients with chest pain and normal coronary arteries can experience exercise-induced left ventricular dysfunction. This study highlights potential cardiac issues beyond typical coronary artery disease, impacting exercise performance.

    Area of Science:

    • Cardiology
    • Nuclear Cardiology
    • Exercise Physiology

    Background:

    • Chest pain with normal coronary arteries is a common clinical presentation.
    • Exercise electrocardiogram changes can suggest ischemia but may not correlate with obstructive coronary artery disease.

    Purpose of the Study:

    • To evaluate left ventricular (LV) performance during exercise in patients with chest pain, ischemic ECG, and normal coronary arteries.
    • To identify potential causes of exercise-induced LV dysfunction in this patient group.

    Main Methods:

    • First-pass radionuclide angiocardiography (RNA) assessed LV function at rest and during maximal upright bicycle exercise.
    • Thallium-201 (201TI) imaging was performed post-exercise and ergonovine testing in select patients.
    • Coronary arteries were assessed angiographically and found to be normal at rest.

    Main Results:

    • Resting LV performance was normal in all 31 patients.
    • Abnormal ejection fraction response to exercise occurred in 12 patients (39%).
    • Exercise-induced 201TI perfusion defects were observed in 5 patients; ergonovine testing did not suggest coronary spasm.

    Conclusions:

    • A significant subset of patients with chest pain and normal coronary arteries exhibits exercise-induced left ventricular dysfunction.
    • This dysfunction may occur independently of obstructive coronary artery disease or coronary spasm.
    • Radionuclide angiocardiography is valuable for detecting exercise-induced LV dysfunction in patients with unexplained chest pain.

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