[Exercise capacity in coronary artery disease evaluated by continuous wave Doppler flowmetry].
In this study the effects of exercise on peak aortic flow velocity (PFV), and the relationship between the maximum change in PFV and the extent of ischemia or infarction were examined. In 16 normal controls (NC) and 83 patients (pts) with documented coronary artery disease, continuous wave Doppler echocardiography and thallium-201 scintigraphy were performed simultaneously during supine bicycle exercise. The patients were grouped according to their results of thallium perfusion imaging: Group (G) 1 (10 pts) = normal; G-2 (30 pts) = ischemia without old infarction, G-3 (23 pts) = old infarction without angina, and G-4 (20 pts) = angina with old infarction. Three different PFV responses to exercise were observed. In NC, PFV increased progressively with exercise. In 28 pts (G-1 = 10, G-2 = 2, G-3 = 11, G-4 = 5), PFV increased as in NC (Type I). In 43 pts (G-2 = 24, G-3 = 9, G-4 = 10), PFV increased at the initial stage but was unchanged or decreased at the final stage (Type II). In 12 pts (G-2 = 4, G-3 = 3, G-4 = 5), PFV decreased progressively with exercise (Type III). The incidence of acute ischemia was 25% (7/28) in Type I, 79% (34/43) in Type II and 75% (9/12) in Type III. Furthermore, Doppler and scintigraphic studies were repeated during exercise in 16 pts (Type II = 14, Type III = 2) who underwent percutaneous transluminal coronary angioplasty (PTCA). After PTCA, in 11 of the 16 pts, the images of acute ischemia nearly resolved and profile of the PFV changed from Type II or III to Type I. In the remaining five patients, the results of both studies were unchanged. Finally, the maximum change of PFV showed good correlation with the extent of ischemia and/or prior infarction (in G-2, r = -0.50, p less than 0.01; in G-3 except for 11 pts of Type I, r = -0.76, p less than 0.01; in G-4, r = -0.80, p less than 0.001). The extents of ischemia and infarction in each group were considered to be far greater in Type III than those in the other Types. These results show that changing of PFV during exercise are related with the presence and extent of acute ischemia and/or infarction.
Kawazoe
Y
Y
Department of Cardiology, Tarumizu Central Hospital, Kagoshima.
Kihara
K
K
Minagoe
S
S
Arima
S
S
Tanaka
H
H
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001011:Aorta / Q000503:physiopathology; D001783:Blood Flow Velocity; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D015150:Echocardiography, Doppler; D015444:Exercise; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000503:physiopathology