The divergent recovery of ST-segment depression and radionuclide angiographic indicators of myocardial ischemia.
This study evaluated the recovery after exercise of both ST-segment depression on the exercise electrocardiogram (electrical evidence of ischemia) and exercise-induced abnormalities in wall motion or ejection fraction as detected by radionuclide angiography. The study group of 31 patients was selected to undergo prolonged electrocardiographic and radionuclide imaging after exercise because they had persistent ST-segment depression greater than 3 minutes after exercise and radionuclide angiographic evidence of ischemia at peak exercise. In 27 (87%) of the 31 patients, radionuclide evidence of ischemia recovered more quickly than the electrocardiogram. Only 15 of the 31 patients had exercise-induced radionuclide abnormalities after exercise. Compared with the 16 patients without such findings of ischemia after exercise, these 15 patients had a worse wall motion score at peak exercise (5.3 vs 3.9; p less than 0.01) and a smaller increase in systolic blood pressure with exercise (p less than 0.05) and after exercise (p less than 0.01). Radionuclide angiographic evidence of ischemia recovers more quickly after exercise than ST-segment depression. When there is radionuclide evidence of ischemia after exercise, it is associated with more severe ischemia during exercise.
Vatterott
P J
PJ
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic 55905.
Hanley
P C
PC
Mankin
H T
HT
Gibbons
R J
RJ
D001794:Blood Pressure; D003326:Coronary Circulation; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans; D011875:Radionuclide Angiography / Q000379:methods; D013997:Time Factors