title: Comparison of exercise performance in left main and three-vessel coronary artery disease.
abstract: 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.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: R J
authors.initials: RJ
authors.lastname: Gibbons
authors.forename: F E
authors.initials: FE
authors.lastname: Fyke
authors.forename: M L
authors.initials: ML
authors.lastname: Brown
authors.forename: A C
authors.initials: AC
authors.lastname: Lapeyre
authors.forename: A R
authors.initials: AR
authors.lastname: Zinsmeister
authors.forename: I P
authors.initials: IP
authors.lastname: Clements
mesh_terms: 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