title: Clinical and hemodynamic significance of left ventricular diastolic volume changes by exercise radionuclide ventriculography in coronary artery disease.
abstract: Recent studies have suggested that left ventricular (LV) dilatation during exercise radionuclide ventriculography may identify coronary artery disease (CAD). Coronary anatomy and LV end-diastolic pressure at catheterization were compared with results of supine exercise radionuclide ventriculography in 66 patients evaluated for chest pain. Forty-six patients had significant CAD (greater than 75% diameter stenosis) and 20 patients were normal. Radionuclide ventriculography was performed within 18 hours of catheterization, at rest and at peak exercise. Relative LV end-diastolic volumes were extrapolated from end-diastolic counts. LV end-diastolic counts increased during exercise in 19 of 20 normal subjects. In patients with CAD, LV end-diastolic counts increased in 35 (group A) and decreased in 11 (group B). The percent change in LV end-diastolic counts from rest to exercise, rest ejection fraction, exercise ejection fraction and rest LV end-diastolic pressure for each group were 20 +/- 23%, 60 +/- 13%, 67 +/- 13% and 8 +/- 3 mm Hg in normal subjects; 20 +/- 20%, 50 +/- 12%, 47 +/- 13% and 12 +/- 4 mm Hg in group A; and -9 +/- 8%, 54 +/- 21%, 49 +/- 18% and 21 +/- 7 mm Hg in group B (mean +/- standard deviation). An increase in LV end-diastolic counts was unrelated to ejection fraction response or presence of underlying CAD but only correlated to rest LV end-diastolic pressure (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Medicine, George Washington University Medical Center, Washington DC 20037.
authors.forename: B W
authors.initials: BW
authors.lastname: Choi
authors.forename: A G
authors.initials: AG
authors.lastname: Wasserman
authors.forename: R J
authors.initials: RJ
authors.lastname: Katz
authors.forename: V
authors.initials: V
authors.lastname: Varma
authors.forename: R C
authors.initials: RC
authors.lastname: Reba
authors.forename: A M
authors.initials: AM
authors.lastname: Ross
mesh_terms: D006328:Cardiac Catheterization; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011875:Radionuclide Angiography; D013318:Stroke Volume