title: The utility of cardiopulmonary exercise testing in the assessment of suspected microvascular ischemia.
abstract: Evidence demonstrating the potential value of cardiopulmonary exercise testing (CPET) to accurately detect myocardial ischemia secondary to macro-vascular disease is beginning to emerge. Despite distinct mechanisms mediating ischemia in micro-vascular and macrovascular coronary artery disease (CAD), the net physiologic effect of exercise-induced left ventricular (LV) dysfunction is common to both. The abnormal physiologic response to CPET may, therefore, be similar in patients with macro- and micro-vascular ischemia. The following case report describes the CPET abnormalities in a patient with suspected microvascular CAD and the subsequent improvement in LV function following three weeks of medical therapy with the anti-ischemic drug ranolazine.
authors.forename: Sundeep
authors.initials: S
authors.lastname: Chaudhry
authors.forename: Ross
authors.initials: R
authors.lastname: Arena
authors.forename: Karlman
authors.initials: K
authors.lastname: Wasserman
authors.forename: James E
authors.initials: JE
authors.lastname: Hansen
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Lewis
authors.forename: Jonathan
authors.initials: J
authors.lastname: Myers
authors.forename: Romualdo
authors.initials: R
authors.lastname: Belardinelli
authors.forename: Brian
authors.initials: B
authors.lastname: LaBudde
authors.forename: Nicholas
authors.initials: N
authors.lastname: Menasco
authors.forename: William E
authors.initials: WE
authors.lastname: Boden
mesh_terms: D005080:Exercise Test / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000503:physiopathology*