Hemodynamic characteristics of patients with coronary artery disease presenting false-negative exercise stress test.
The present study was designed to clarify the characteristics of left ventricular hemodynamics and coronary arteries in patients with coronary artery disease presenting false-negative response to the Master's two-step stress test. Eighty-eight consecutive patients performed the Master's two-step stress test and had coronary angiography for evaluation of suspected or known coronary artery disease. The frequency of false-negative and true-positive responses in the Master's two-step stress test was 20% and 45%, respectively. Elevated left ventricular end-diastolic pressure, reduced ejection fraction, and low cardiac output characterized the left ventricular hemodynamics in patients with false-negative responses, as compared with those with true-positive response. The severity and extent of coronary artery disease, as well as prior myocardial infarction, did not affect the frequency of false-negative response. This study indicates that the false-negative response to the Master's two-step test is unexpectedly frequent in coronary artery disease with severe left ventricular dysfunction. Thus, one should be careful in judging the results of the Master's two-step test in symptomatic patients with severe left ventricular dysfunction.
Sekiya
M
M
Second Department of Internal Medicine, Ehime University School of Medicine, Japan.
Suzuki
M
M
Fujiwara
Y
Y
Sumimoto
T
T
Hamada
M
M
Hiwada
K
K
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002302:Cardiac Output; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis* / Q000503:physiopathology; D004562:Electrocardiography; D005080:Exercise Test / Q000379:methods; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D016277:Ventricular Function, Left