Long-term follow-up of patients initially diagnosed with syndrome X.
The clinical course of 30 patients (27 women and 3 men) diagnosed with syndrome X (angina pectoris, positive exercise test and normal coronary arteries) was evaluated during 5-year follow up. Patients were divided at the control examination into 2 groups according to the median value of the heart rate/blood pressure product variation from rest to the first stage of a modified Bruce protocol, as follows: group 1 < or = 1,050 (n = 15) and group 2 > 1,050 mm Hg x beats/min (n = 15). All patients were followed at 6-month intervals during a mean follow-up of 60 +/- 8 months. During follow-up, chest pain was unchanged in 20 patients, decreased in severity and frequency in 9 (7 in group 1, and 2 in group 2), and disappeared in 1 in group 2; 3 patients in group 1 had prolonged episodes of anginal chest pain (> 30 minutes) that needed hospitalization. In group 2, 7 patients developed systemic hypertension, 4 had a progression of exercise-induced left bundle branch block to constant left bundle branch block, and 4 continued to develop rate-dependent block during exercise, but at a reduced heart rate. In the latter 8 patients, left ventricular ejection fraction at rest during follow-up decreased significantly from 61 +/- 6% to 51 +/- 8% (p < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
Romeo
F
F
Department of Cardiology II, University of Rome, Italy.
Rosano
G M
GM
Martuscelli
E
E
Lombardo
L
L
Valente
A
A
D000328:Adult; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000503:physiopathology; D015331:Cohort Studies; D017023:Coronary Angiography; D003326:Coronary Circulation; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D013564:Sympathetic Nervous System / Q000503:physiopathology; D013577:Syndrome