Comparison of exercise performance in left main and three-vessel coronary artery disease.
From a consecutive series of patients who underwent rest and exercise radionuclide angiography over several years, we retrospectively identified 34 patients with left main coronary artery disease and 103 patients with three-vessel coronary artery disease who did not have significant left main disease. The results of gated equilibrium radionuclide angiography were compared in these 2 groups. Multiple exercise hemodynamic, exercise electrocardiographic, and exercise radionuclide angiographic parameters were considered in an attempt to separate the 2 groups. The only parameter that was significantly different between the 2 groups was exercise heart rate. However, no value of the exercise heart rate could meaningfully separate the 2 groups. Despite their known difference in prognosis, patients with left main and three-vessel disease had very similar exercise performance and could not be distinguished from one another by exercise electrocardiography or exercise radionuclide angiography. The inability to distinguish these two groups is a clear limitation of noninvasive exercise modalities.
Gibbons
R J
RJ
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905.
Fyke
F E
FE
Brown
M L
ML
Lapeyre
A C
AC
Zinsmeister
A R
AR
Clements
I P
IP
D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D004562:Electrocardiography; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D015637:Gated Blood-Pool Imaging; D006321:Heart / Q000000981:diagnostic imaging*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D012044:Regression Analysis; D012189:Retrospective Studies