[Prognostic significance of silent ischemia in the exercise test in patients with coronary disease].
To evaluate the prognostic significance of silent ischemia during exercise testing, 152 consecutive patients (143 males, 9 females) with a mean SD of 55 +/- 7 years (age range 32-73) who underwent exercise testing and coronary arteriography within 3 months were studied. All patients had the following characteristics: 1) a positive electrocardiographic exercise test response; 2) significant coronary artery disease on the arteriography; 3) uninterrupted clinical follow-up for a minimum of 6 months. The 152 patients were divided in 2 groups: group I: 56 patients (37%) with ischemic ST-segment depression during exercise testing without angina (silent ischemia); group II: 96 patients (63%) with ischemic ST-segment depression and angina (symptomatic ischemia). Patients in group I and group II showed similar time to ST-segment depression (3.6 +/- 1.5 min vs 3.2 +/- 1.4 min; p = NS), maximal ST-segment depression and peak heart rate-systolic pressure product (21,151 +/- 7,124 vs 20,456 +/- 6,024; p = NS). Exercise duration was longer in group I than in group II (5.6 +/- 2.1 min vs 4.8 +/- 1.5 min; p less than 0.001). The extent of coronary artery disease defined by the number of significant narrowed coronary vessels, left ventricular end diastolic pressure and ejection fraction were similar in the 2 groups. Sixty six patients who underwent coronary bypass surgery were not included in the analysis. The remaining 86 patients (40 in group I and 46 in group II) were medically treated. The mean follow-up period was 43,5 +/- 25 months (range 6-101).2+ myocardial ischemia during exercise testing.
Marín Huerta
E
E
Servicio de Cardiología, Hospital Ramón y Cajal, Madrid.
Moya Mur
J L
JL
de Pablo
C
C
Rayo
I
I
Muela
A
A
Martín de Dios
R
R
Moro
C
C
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000503:physiopathology; D003327:Coronary Disease / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis
Significado pronóstico de la isquemia silente durante la prueba de esfuerzo en pacientes con enfermedad coronaria.