Noninvasive evaluation of progression of ischemic heart disease: 5 year follow-up.
Left ventricular (LV) apexcardiogram can be used for the assessment of LV diastolic abnormalities during isometric handgrip stress. In the present study, the clinical value of handgrip-apexcardiographic test (HAT) for identifying patients with new ischemia by the assessment of LV diastolic abnormalities during HG was prospectively investigated. After 5 years follow-up, 9 at entry asymptomatic patients with prior infarction developed a slight effort angina pectoris as a sign of progression of the disease. The data of HAT obtained at entry were compared with those within one month after the onset of angina. As apexcardiographic indices of LV diastolic function the relative A-wave to total height (A/H) and the total apexcardiographic relaxation time (TART) of the apex tracing were used. In 243 controls A/H averaged at rest 10 +/- 4% and TART 107 +/- 9 ms and changed only slightly during and after handgrip stress. Both indices were in patients at rest and during HAT within normal limits at entry. At 5 years, TART was longer (123 +/- 13 ms) and A/H unchanged at rest. During and after handgrip, however, A/H increased significantly (29 +/- 9% and 24 +/- 6%, respectively, p less than 0.01), whereas TART showed no significant change. Furthermore, all patients had an abnormal A-wave response to isometric stress (A/H during or/and after handgrip higher than 21%, which is the largest individual value in the controls).(ABSTRACT TRUNCATED AT 250 WORDS)
Manolas
J
J
Diagnostic and Therapeutic Center of Athens, Hygeia, Greece.
D000293:Adolescent; D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000175:diagnosis* / Q000453:epidemiology; D004562:Electrocardiography; D005500:Follow-Up Studies; D006801:Humans; D007702:Kinetocardiography; D008297:Male; D008875:Middle Aged; D010701:Phonocardiography