Diagnostic accuracy of exercise stress testing for coronary artery disease: a systematic review and meta-analysis of prospective studies

Banerjee, Amitava; Newman, David; Bruel, Ann Van den; Heneghan, Carl

doi:10.1111/j.1742-1241.2012.02900.x

Cited by 114 publications

(83 citation statements)

References 108 publications

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“…The coronary arteries were assessed using the 17-segment AHA model. Disease of the epicardial coronary arteries hypoxia appears to be generally unable to correct myocardial ischemia that is detected using the exercise stress test (EST) (1). The presence of spare A 2A R in CAD patients and its role in CAD pathophysiology in which the regulation of myocardial blood flow is altered have never been addressed, and we hypothesized that spare A 2A R is present in CAD patients to try to correct myocardial ischemia.…”

Section: Est Proceduresmentioning

confidence: 99%

“…The ensuing low oxygen level in the myocardium triggers coronary vasodilation (1) 3 Nathalie Kipson, 1 Giovanna Mottola, 1 Julien Fromonot, 1,4 Jocelyne Condo, 1 Alain Boussuges, 1 Laurie Bruzzese, 1 François Kerbaul, 5 Yves Jammes, 1 Vlad Gariboldi, 6 Frédéric Franceschi, 1 Emmanuel Fenouillet, 1,7 and Régis Guieu was considered to be significant if the stenosis was ≥ 70% in a major coronary artery. The treatment of the patients was conservative.…”

Section: Introductionmentioning

confidence: 99%

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Spare Adenosine A2a Receptors Are Associated with Positive Exercise Stress Test in Coronary Artery Disease

Ruf

Paganelli

Bonello

et al. 2016

Mol Med

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During exercise, cardiac oxygen consumption increases and the resulting low oxygen level in the myocardium triggers coronary vasodilation. This response to hypoxia is controlled notably by the vasodilator adenosine and its A 2A receptor (A 2A R). According to the "spare receptor" pharmacological model, a strong A 2A R-mediated response can occur in the context of a large number of receptors remaining unoccupied, the activation of only a weak fraction of A 2A R (evaluated using K D ), which results in maximal cAMP production (evaluated using EC 50 ), and hence in maximal coronary vasodilation. In coronary artery disease (CAD), myocardial ischemia limits adaptation to exercise, which is commonly detected using the exercise stress test (EST). We hypothesized that spare A 2A R is present in CAD patients to correct ischemia. Seventeen patients with angiographically documented CAD and 17 control subjects were studied. We addressed adenosine-plasma concentration and A 2A R-expression at the mononuclear cell-surface, which reflects cardiovascular expression. The presence of spare A 2A R was tested using an innovative pharmacological approach based on a homemade monoclonal antibody with agonist properties. EST was positive in 82% of patients and in none of the controls. Adenosine plasma concentration increased by 60% at peak exercise in patients and in none of the controls (p < 0.01). Most patients (65%), and none of the controls, had spare A 2A R (identified when EC 50 /K D ≤ 0.1) and a low A 2A R-expression (mean: -37% versus controls; p < 0.01). All patients with spare A 2A R had a positive EST whereas the subjects without spare A 2A R had a negative EST (p < 0.05). Spare A 2A R is therefore associated with positive EST in CAD patients and its detection may be used as a diagnostic marker.

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Section: Est Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spare Adenosine A2a Receptors Are Associated with Positive Exercise Stress Test in Coronary Artery Disease

Ruf

Paganelli

Bonello

et al. 2016

Mol Med

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show abstract

“…Посредством мета-анализа было показано, что диа-гностическая точность нагрузочных тестов зависела от возраста, пола, клинических характеристик, вида нагрузочного теста, а также от используемого прото-кола теста [18,19]. Так, у больных с однососудистым поражением нагрузочные тесты с постепенным уве-личением нагрузки зачастую не выявляют ишемию миокарда, несмотря на наличие симптомов стено-кардии, возникающих при каких-то особых усло-виях.…”

Section: таблицаunclassified

The Prevalence of Intact Coronary Arteries in Relation With Indications for Scheduled Coronary Arteriography

Корок¹,

Сумин²,

Синьков³

et al. 2016

Russ J Cardiol

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“…В реальной клинической практике диагно-стическая точность нагрузочных тестов зависит от не-скольких основных показателей: возраста, пола, клиниче-ских характеристик, вида и протокола нагрузочного теста [9]. Например, у больных с однососудистым поражением тесты с постепенным увеличением нагрузки чаще не вы-являют ишемию миокарда, несмотря на наличие симпто-мов стенокардии, возникающих в других условиях.…”

Section: рис 3 характеристика стенокардии в выделенных группахunclassified

Factors associated with intact coronary arteries identification during routine coronarography

Korok¹,

Сумин²,

Барбараш³

2015

Kardiol. serdechno-sosud. khir.

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Diagnostic accuracy of exercise stress testing for coronary artery disease: a systematic review and meta-analysis of prospective studies

Cited by 114 publications

References 108 publications

Spare Adenosine A2a Receptors Are Associated with Positive Exercise Stress Test in Coronary Artery Disease

Spare Adenosine A2a Receptors Are Associated with Positive Exercise Stress Test in Coronary Artery Disease

The Prevalence of Intact Coronary Arteries in Relation With Indications for Scheduled Coronary Arteriography

Factors associated with intact coronary arteries identification during routine coronarography

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