Left ventricular performance during exercise testing in patients with silent and symptomatic myocardial ischemia.
We compared cardiohemodynamic response to dynamic exercise in 32 patients with exercise-induced silent or symptomatic myocardial ischemia. All patients had coronary artery disease without prior myocardial infarction and left ventricular hypertrophy. Patients underwent supine leg-exercise testing and received right heart catheterization. All patients exhibited ischemic ST-segment depression on electrocardiogram during exercise testing. They were classified retrospectively into two groups according to the absence (n = 10, group 1) or presence (n = 22, group 2) of chest pain induced by exercise. There was no significant difference between groups in the magnitude of peak ST-segment depression. Pulmonary artery wedge pressure at peak exercise was significantly lower (p < 0.01), and the cardiac index was significantly higher (p < 0.01), in group 1 versus group 2. Our results indicate that exercise-induced left ventricular dysfunction is less severe in patients with silent myocardial ischemia than in those with symptomatic ischemia.
Matsubara
K
K
First Department of Internal Medicine, Nagoya University School of Medicine, Japan.
Yokota
M
M
Miyahara
T
T
Sobue
T
T
Iwase
M
M
Saito
H
H
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003327:Coronary Disease / Q000175:diagnosis / Q000503:physiopathology*; D005080:Exercise Test; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology*