Exercise P-vector magnitude changes in angina pectoris: Frank-Vectorcardiographic and hemodynamic correlations.
Multistage bicycle ergometer exercise testings with Frank vectorcardiogram and M-mode echocardiogram were performed on 12 patients with effort angina pectoris. The left atrial and left ventricular end-diastolic volume (LAV and LVEDV) were calculated as a cube of the left atrial and left ventricular end-diastolic dimension. The mean pulmonary artery wedge pressure (mPAWP) was measured with a Swan-Ganz catheter during the testing. At peak exercise a statistically significant increase was observed in mPAWP (p less than 0.001), LAV (p less than 0.005), the maximal horizontal P-vector magnitude (Hmax) (p less than 0.05) and the percent change in Hmax (%Hmax). %Hmax showed a significant correlation with the increment of mPAWP (delta mPAWP) (r = 0.66, p less than 0.05), the increment of LVEDV (delta LVEDV) (r = 0.83, p less than 0.01) and the increment of LAV (delta LAV) (r = 0.81, p less than 0.001). Multiple regression analysis was performed on %Hmax as a dependent variable with delta LAV, delta mPAWP, and the increment of heart rate (delta HR) as independent variables (r = 0.84, p less than 0.05), but the partial correlation coefficients of delta mPAWP and delta HR were not significant. The present study demonstrated that the increase in Hmax had a close relationship with the increase in mPAWP and LVEDV and that the preload of the left ventricle during exercise-induced anginal attack could be predicted noninvasively by %Hmax. The increase in Hmax was thought to be due to the increase in LAV during anginal attack.
M
M
Yokota
H X
HX
Jing
S
S
Takagi
A
A
Tsunekawa
M
M
Koide
M
M
Iwase
M
M
Tsuzuki
R
R
Yoshida
I
I
Sotobata
D000328:Adult; D000787:Angina Pectoris / Q000175:diagnosis* / Q000503:physiopathology; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis* / Q000503:physiopathology; D004452:Echocardiography / Q000379:methods; D005080:Exercise Test; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D014672:Vectorcardiography / Q000379:methods*