Left ventricular diastolic performance at rest and during exercise in patients with coronary artery disease. Assessment with first-pass radionuclide angiography.

Reduto, Lawrence A.; Wickemeyer, W. J.; Young, James B.; Ventura, Laurie; Reid, John Warren; Glaeser, Donald H.; Quiñones, Miguel Á.; Miller, Richard R.

doi:10.1161/01.cir.63.6.1228

Cited by 220 publications

(46 citation statements)

References 26 publications

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“…Normalized peak filling rate was significantly lower in group 2 than in group 1 (figure 4; table 2), which is in agreement with results obtained with gated radionuclide ventriculography3' 6,8 and with contrast ventriculography' or firstpass radionuclide ventriculography. 4 agreement with the findings of Slutsky et al 7 These results indicate that left ventricular diastolic filling could be impaired at rest in many patients with coronary artery disease who have had no previous myocardial infarction. Regional diastolic phase function.…”

Section: Diastolic Phase Indexessupporting

confidence: 92%

Asynchronous left ventricular diastolic filling in patients with isolated disease of the left anterior descending coronary artery: assessment with radionuclide ventriculography.

Yamagishi¹,

Ozaki²,

Kumada³

et al. 1984

Circulation

106

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To study the relationship between global and regional filling of the left ventricle, we conducted resting gated radionuclide ventriculographic studies in 15 control subjects (group 1) and 22 patients with isolated disease of the left anterior descending coronary artery (group 2). None had had a previous myocardial infarction. A computer program subdivided the image of the left ventricle into four regions. The time-activity and first-derivative curves of the global and regional left ventricles were computed. In the global left ventricle, the normalized peak filling rate (PFR) was decreased (p < .01) and the ratio of the time to PFR (time interval from global end-systole to PFR) to the diastolic time, TPFR/DT, was greater (p < .02) in group 2 than in group 1. In the regional left ventricle, in the side perfused by the stenosed vessel (septal and apical), PFR was slightly decreased in the apical (p < .05), but not the septal region (p = NS); TPFR/DT was greater in the apical (p < .02) and in the septal region (p < .01) in group 2. In the normally perfused lateral side, there were no significant differences in PFR or in TPFR/DT between group 1 and group 2. Total At/DT, which was defined as the ratio of the sum of the absolute values of the time differences from global PFR to regional PFR (septal, apical, and lateral) to the diastolic time, was significantly greater in group 2 (0.09 0.05 vs 0. 16 + 0.05; p < .001). This indicates the existence of asynchronous diastolic filling in the different regions of the left ventricle in group 2. A negative correlation existed between total At/DT and global PFR (r -.64, p < .001). Thus, in patients with one-vessel disease, asynchronous diastolic filling occurs due to the filling disturbance in the affected regions, which may cause impairment of the filling of the global left ventricle. Circulation 69, No. 5, 933-942, 1984. LEFT VENTRICULAR diastolic filling has been reported to be impaired in many patients with coronary artery disease in whom there is no evidence of previous myocardial infarction. 8

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Section: Diastolic Phase Indexessupporting

confidence: 92%

Asynchronous left ventricular diastolic filling in patients with isolated disease of the left anterior descending coronary artery: assessment with radionuclide ventriculography.

Yamagishi¹,

Ozaki²,

Kumada³

et al. 1984

Circulation

106

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“…End-systole was defined as the time of aortic valve closure, and enddiastole was defined as the time of the R-wave peak in the electrocardiogram. SI-DI was determined 18,19) as (A-B)/A × 100% (Figure 1), as previously described. 12,13) At the same time, PSLS was measured in each LV segment, and global PSLS was calculated as the average PSLS of all 18 segments.…”

Section: Methodsmentioning

confidence: 99%

Prediction of Coronary Artery Stenosis at Rest in Patients With Normal Left Ventricular Wall Motion

et al. 2013

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SummaryNoninvasive detection of coronary artery stenosis usually requires a stress test in patients without left ventricular (LV) regional wall motion abnormalities (RWMA). In contrast, abnormal regional LV relaxation caused by ischemia may persist beyond recovery from transient ischemia. The aim of the present study was to determine whether segmental analysis of abnormal regional LV relaxation using the strain imaging diastolic index (SI-DI) at rest could predict coronary artery stenosis in the three major vessels in patients without LV dysfunction or RWMA. We performed 2D speckle tracking echocardiography and coronary angiography in 85 patients without RWMA with suspected coronary artery disease. Patients with LV dysfunction or acute coronary syndrome were excluded. Echocardiographic images of the LV were obtained in the apical 2-, 3-, and 4-chamber views and divided into 6 segments. In each segment, SI-DI derived from transverse strain imaging was determined. Forty-eight patients had significant coronary artery stenosis (≥ 70%). The optimal cutoff values of SI-DI were 60.5% in the mid anteroseptal segment for detecting left anterior descending artery stenosis (sensitivity, 83.3%; specificity, 81.1%), 60.5% in the basal anterolateral segment for detecting left circumflex artery stenosis (sensitivity, 80.9%; specificity, 90.3%), and 61.5% in the basal inferior segment for detecting right coronary artery stenosis (sensitivity, 74.1%; specificity, 77.8%). A segmental analysis of SI-DI at rest predicted coronary artery stenosis in the three major vessels in patients without RWMA. This noninvasive method may be useful for detecting coronary artery stenosis without a stress test. (Int Heart J 2013; 54: 266-272)

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“…19 in patients with multivessel disease, and from -0. 13 abnormalities, and 37 of 40 (93%) with anterior circulation disease and posterior infarction had septal abnormalities (p < .05). However, only nine of 20 patients without multivessel disease had completely normal wall motion in the remote region at peak exercise (specificity = 45%).…”

Section: Methodsmentioning

confidence: 95%

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The question asked of the test in a patient being diagnosed ("Is disease present?") differs from that in a postinfarction patient ("Is additional disease present?").…”

mentioning

confidence: 99%

Noninvasive prediction of the angiographic extent of coronary artery disease after myocardial infarction: comparison of clinical, bicycle exercise electrocardiographic, and ventriculographic parameters.

Morris¹,

Rozanski²,

Berman³

et al. 1984

Circulation

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To assess alternative criteria for the prediction of multivessel coronary artery disease after myocardial infarction, we compared the clinical, bicycle electrocardiographic, and radionuclide ventriculographic (ejection fraction and wall motion) responses in 110 patients undergoing coronary angiography after myocardial infarction. Ninety-seven of the 1 10 patients had multivessel coronary artery disease (two or more diseased vessels). Clinical or electrocardiographic abnormalities were observed in 41 of 97 (sensitivity = 43%) patients with multivessel disease, and in only two of 13 (specificity = 85%) patients without multivessel disease. The average information content of these combined clinical and electrocardiographic variables relative to perfect discrimination was 5%. Among the scintigraphic parameters, the conventional criterion for ejection fraction abnormality, a rise of less than 5% had a sensitivity of 72% and a specificity of 62% for multivessel coronary artery disease, while a fall in ejection fraction of 5% or more had a sensitivity of 39% and specificity of 92% for multivessel coronary artery disease. The presence of an exercise wall motion abnormality in the nonadjacent noninfarcted (remote) region had a sensitivity of 82% and specificity of 55% for multivessel coronary artery disease. A more stringent criterion, worsening of remote wall motion with exercise, had a sensitivity of 52% and specificity of 75%. When this latter criterion was combined with a fall in ejection fraction, the sensitivity for multivessel coronary artery disease increased to 62%, specificity remained 75%, and information content increased from 5% to 10%. We conclude that conventional diagnostic criteria for abnormal clinical, bicycle electrocardiographic, or scintigraphic results do not identify patients with additional coronary artery disease after infarction with high accuracy. Two alternative ventriculographic parameters a fall in ejection fraction and wall motion worsening -are similar to clinical parameters in specificity, but have a higher sensitivity and information content. Circulation 70, No. 2, 192-201, 1984. IN MOST exercise radionuclide laboratories the same criteria for abnormality appear to be used in patients referred for diagnosis of coronary artery disease as in those with previous myocardial infarction referred for functional evaluation. Thus 192pooled patients referred for diagnosis and postinfarction patients in determining the sensitivity and specificity of exercise radionuclide ventriculography or applied the same criterion of abnormality to the separate populations. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The question asked of the test in a patient being diagnosed ("Is disease present?") differs from that in a postinfarction patient ("Is additional disease present?"). For the postinfarction patient, in whom disease is almost always present, the goal of testing is to predict prognosis. However, in the absence of a large body of data regarding prognosis, a decision...

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Left ventricular diastolic performance at rest and during exercise in patients with coronary artery disease. Assessment with first-pass radionuclide angiography.

Cited by 220 publications

References 26 publications

Asynchronous left ventricular diastolic filling in patients with isolated disease of the left anterior descending coronary artery: assessment with radionuclide ventriculography.

Asynchronous left ventricular diastolic filling in patients with isolated disease of the left anterior descending coronary artery: assessment with radionuclide ventriculography.

Prediction of Coronary Artery Stenosis at Rest in Patients With Normal Left Ventricular Wall Motion

Noninvasive prediction of the angiographic extent of coronary artery disease after myocardial infarction: comparison of clinical, bicycle exercise electrocardiographic, and ventriculographic parameters.

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