[Mechanism of exercise-induced ST depression based on hemodynamics during cardiac catheterization].
OBJECTIVE
The cause of exercise-induced ST depression was studied by assessing left ventricular end-diastolic pressure (LVEDP).


METHODS
This study included 28 patients with normal coronary artery, 24 patients with vasospastic angina pectoris and 28 patients with fixed organic lesion who underwent both treadmill exercise testing and selective coronary arteriography. Exercise-induced ST deviation was considered as maximal ST deviation during the exercise test and maximum LVEDP was considered as the pressure measured 1 min after left ventriculography.


RESULTS
The degree of exercise-induced ST depression in aVF showed no significant differences between the three groups. Exercise-induced ST elevation occurred in the intracardiac leads and exercise-induced ST depression occurred in the epicardial leads. These electrocardiographic changes were not contradictory to subendocardial ischemia. In addition, there was a good correlation (r = - 0.465, p < 0.01) between exercise-induced ST depression and maximum LVEDP elevation.


CONCLUSIONS
Exercise-induced ST depression was caused by subendocardial ischemia due to increased LVEDP.
Noike
Hirofumi
H
Cardiovascular Center, Sakura Hospital, Toho University School of Medicine, Shimoshizu 564-1, Sakura, Chiba 285-0841. hfnoike@sakura.med.toho-u.ac.jp
Hitsumoto
Takashi
T
Sugiyama
Yuko
Y
Sakurai
Takeshi
T
Satoh
Shin
S
Iizuka
Takuo
T
Takahashi
Mao
M
Shimizu
Kazuhiro
K
Nakamura
Keijiro
K
Ohsawa
Hidefumi
H
D000368:Aged; D006328:Cardiac Catheterization; D003327:Coronary Disease / Q000503:physiopathology*; D003971:Diastole; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016277:Ventricular Function, Left