Measurement of the Angina Threshold Using Atrial Pacing: A New Technique for the Study of Angina Pectoris

Sowton, G. E.; Balcon, Raphael; Cross, David F.; Frick, M. H.

doi:10.1093/cvr/1.4.301

Cited by 200 publications

(16 citation statements)

References 24 publications

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“…4 6 In humans, the demonstration of transient alterations in left ventricular function during myocardial ischemia has required either artrial pacing or exercise with ventriculography. 6 8 Recently, regional left ventricular performance was assessed at cardiac catheterization during spontaneous angina pectoris.9 Little'information is available, however, on serial changes in regional myocardial function caused by myocardial ischemia in humans. The pathophysiologic basis of the syndrome of unstable angina appears to be transient limitation of coronary blood flow.10 Thus, patients with unstable angina are ideal for the study of serial changes in segmental wall motion.…”

mentioning

confidence: 99%

Identification of transient and persistent segmental wall motion abnormalities in patients with unstable angina by two-dimensional echocardiography.

Nixon¹,

Brown²,

Smitherman³

1982

Circulation

164

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To determine the value of real-time, two-dimensional echocardiography (2-D echo) in unstable angina, regional wall motion on serial short-axis 2-D echo recordings was analyzed and summed segment scores of abnormal motion were compared and classified according to each patient's clinical status 12 weeks after hospital discharge. Nineteen male patients who fulfilled criteria for unstable angina and responded to medical therapy underwent 2-D echo study within 48 hours of admission and discharge. Of 11 patients with abnormal 2-D echo scores on admission, five patients had reduced scores and six patients had similar or increased scores at discharge. Six of eight patients who had scores of zero on admission had scores of zero at discharge. At follow-up, 11 patients had minimal or no angina pectoris (group 1), and eight patients had worsening angina or recurrent unstable angina (group 2). At discharge, 2-D echo studies showed that all group 1 patients had reduced or zero scores, while group 2 patients retained or increased their abnormal scores. This study shows that in patients with unstable angina, both transient and persistent abnormalities can be identified by 2-D echo. Abnormal segmental wall motion was transient or absent in patients with a good outcome, and worsened or remained abnormal in patients with a poor outcome.

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mentioning

confidence: 99%

Identification of transient and persistent segmental wall motion abnormalities in patients with unstable angina by two-dimensional echocardiography.

Nixon¹,

Brown²,

Smitherman³

1982

Circulation

164

View full text Add to dashboard Cite

show abstract

“…The patient is comfortable and there are no vio lent respiratory movements to change the rel ative position of the heart in the chest cage. The patient is studied at a constant heart rate during data acquisition and once pacing is stopped, the stimulus for ischemia is re moved immediately [5][6][7][8], Nuclear angiogra phy is simple and relatively noninvasive and permits careful assessment of the induction of ischemic paresis during AP and the benefi cial effect of the protective drug.…”

Section: Discussionmentioning

confidence: 99%

“…Atrial pacing (AP) tachycardia is a simple, reproducible and controlled method of in ducing myocardial ischemia [5,6], Signifi cant stenosis of a coronary artery impairs the normal increase in coronary blood flow dur ing the tachycardia: this induced ischemia causes reversible paresis of the ischemic zone with a spatial and temporal defect in ventric ular contraction and relaxation. Global left ventricular ejection fraction (EF) falls [7,8].…”

Section: -4 ]mentioning

confidence: 99%

The Effect of Nifedipine on Normal and Ischemic Left Ventricular Function during Atrial Pacing Stress

Weiss¹,

Shefer²,

Lewis³

et al. 1984

Cardiology

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We studied 44 patients (group I: 9 with insignificant disease and group II: 35 with significant coronary artery disease) by nuclear angiography during the controlled increase in heart rate by atrial pacing to evaluate the effect of 20 mg of sublingual nifedipine on left ventricular function. Left ventricular volumes were calculated using count-derived changes: end-diastolic (EDE), end-systolic (ESE), stroke volume (SVE) and cardiac output equivalents (COE) and ejection fraction (EF) and ejection rate (ER) were calculated during basal sinus rhythm (C) and at the maximal atrial pacing (AP) rate with and without nifedipine. In normal subjects, AP decreased ventricular volumes. The administration of nifedipine decreased blood pressure but had no further effect on left ventricular volume. In the ischemic ventricle, AP produced reversible ventricular wall paresis with a smaller decrease in EDE, an increase in ESE and a significant fall in EF. Nifedipine induced a striking improvement in EF and ER. This was probably a consequence of afterload reduction and increased coronary blood flow.

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“…Its usefulness in evaluating myocardial flow reserve in coronary artery disease is well known (22). Less appreciated is its ability to test ventricular performance in a variety of heart disease entities (9,10,16,17).…”

Section: Discussionmentioning

confidence: 99%

Left ventricular end‐diastolic pressure response to atrial pacing in idiopathic mitral valve prolapse

Feitosa

Bentivoglio

Uricchio

et al. 1978

Clinical Cardiology

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Summary:The response of several parameters of left ventricular function to right atrial pacing was compared in 21 patients with idiopathic mitral valve prolapse and 10 normal patients. An inability to appropriately lower left ventricular end-diastolic pressure with increasing rates was demonstrated in the mitral valve prolapse group. This abnormality was not related to mitral regurgitation or factors other than ventricular performance per se.

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Measurement of the Angina Threshold Using Atrial Pacing: A New Technique for the Study of Angina Pectoris

Cited by 200 publications

References 24 publications

Identification of transient and persistent segmental wall motion abnormalities in patients with unstable angina by two-dimensional echocardiography.

Identification of transient and persistent segmental wall motion abnormalities in patients with unstable angina by two-dimensional echocardiography.

The Effect of Nifedipine on Normal and Ischemic Left Ventricular Function during Atrial Pacing Stress

Left ventricular end‐diastolic pressure response to atrial pacing in idiopathic mitral valve prolapse

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