[Ambulatory monitoring of left ventricular function: the assessment of transient episodes of ventricular dysfunction in patients with ischemic cardiopathy].
BACKGROUND
The recent development of an ambulatory radionuclide detector (VEST) to assess left ventricular (LV) function may enhance the detection of ischemia during routine daily activities in patients with coronary artery disease (CAD). The aim of this study was to evaluate the usefulness of VEST in monitoring LV ejection fraction (EF) responses to daily activities and sustained handgrip test (HG) in patients with CAD.


METHODS
13 patients (12 men and 1 woman) with angiographically proven coronary artery disease were studied by VEST (mean 162 min, range 120 to 250 min). LV responses to different daily activities (walking and climbing stairs) and to HG were evaluated.


RESULTS
Walking on a level surface and climbing stairs did not induce significant change in mean LVEF. However, a transient decrease in EF was observed in 4 (31%) and in 5 (38%) of the 13 patients during walking and climbing stairs, respectively. HG induced a significant (p < 0.01) reduction in mean EF. In particular, during HG, EF decreased > or = 5% in 11 (85%) of the 13 patients. A transient spontaneous decrease in LVEF lasting > or = 1 min was observed on 18 occasions in 11 patients with CAD; 5 episodes were symptomatic and 13 asymptomatic. ECG ST segment depression was recorded in 4 of the 5 symptomatic and in 5 of the 13 asymptomatic episodes.


CONCLUSIONS
These results suggest that simultaneous monitoring of LV function and ECG may permit a better understanding of the incidence and severity of ischemic symptomatic and asymptomatic episodes.
Cuocolo
A
A
Cattedra in Medicina Nucleare, Università Degli Studi di Napoli Federico II.
Nappi
A
A
Nicolai
E
E
Pace
L
L
Imbriaco
M
M
Morisco
C
C
Chiariello
M
M
Trimarco
B
B
Salvatore
M
M
D000368:Aged; D000704:Analysis of Variance; D015716:Electrocardiography, Ambulatory / Q000295:instrumentation / Q000706:statistics & numerical data; D005260:Female; D015637:Gated Blood-Pool Imaging / Q000295:instrumentation / Q000706:statistics & numerical data; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D012044:Regression Analysis; D013667:Technetium; D016277:Ventricular Function, Left
D013667:Technetium
Monitoraggio ambulatoriale della funzione ventricolare sinistra: valutazione degli episodi transitori di disfunzione ventricolare in pazienti con cardiopatia ischemica.