[Clinical and angiographic expression of myocardial ischemia in stable angina as a function of its coronary reserve].
We have studied the distribution of the coronary reserve, evaluated by serial effort tests, in patients with proved coronaropathy, determining the correlation between clinic (effort and mixed angina) and coronary reserve (fixed and variable), assessing angiographic findings in function to that reserve. We took 120 patients with stable angina to whom 2 effort tests were performed, basal and after vasodilator drugs. It was considered variable reserve if in the second test the S-T descend improved greater than or equal to 1 mm for a similar of greater double product and fixed when it didn't improve. In all patients coronarography was performed. Seventy two patients (60%) showed fixed reserve, 58 with effort angina (80%) and 14 (20%) with mixed. Forty eight showed variable reserve, 40 (80%) with mixed angina and 8 (17%) with effort. The group with fixed reserve had a greater S-T max. descent (2.9 +/- 0.9 vs 2.2 +/- 0.4) (p less than 0.001), a lower double product max. (221 +/- 44 vs 284 +/- 37) (p less than 0.001) and a lower maximal oxygen consumption (MVO2 7 +/- 2 vs 11 +/- 2) (p less than 0.001) than the variable reserve group. Considering the angiography, the fixed reserve group had more number of vessels affected (1.9 +/- 0.7 vs 1.4 +/- 0.5) (p less than 0.01), a higher angiographic score (4.88 +/- 2.4 vs 2.2 +/- 1.2) (p less than 0.001), a lower ejection fraction (59 +/- 8.5 vs 65 +/- 7.5) (p less than 0.001), more multivessel and descending anterior artery lesion than the variable reserve group.(ABSTRACT TRUNCATED AT 250 WORDS)
Salcedo Arruti
A
A
Servicio de Cardiología, Hospital Civil de Bilbao, FVPC.
Iriarte Ezkurdia
M M
MM
Molinero de Miguel
E
E
Echevarría Villegas
M P
MP
Aguirre Salcedo
J M
JM
Sagastagoitia Gorostiza
J D
JD
Arzubiaga Bilbao
J
J
Bóveda Romeo
F J
FJ
D000368:Aged; D000787:Angina Pectoris / Q000503:physiopathology*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D003326:Coronary Circulation / Q000502:physiology*; D003327:Coronary Disease / Q000473:pathology / Q000503:physiopathology; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography
Expresión clínica y angiográfica de la isquemia miocárdica en la angina estable en función de su reserva coronaria.