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Value of left ventricular ejection fraction during exercise in predicting the extent of coronary artery disease.

Abstract：

:To determine the relation between left ventricular performance during exercise and the extent of coronary artery disease, the results of exercise radionuclide ventriculography were analyzed in 65 patients who also underwent cardiac catheterization. A scoring system was used to quantitate the extent of coronary artery disease. This system takes into account the number and site of stenoses of the major coronary vessels and their secondary branches. The conventional method of interpreting the coronary angiograms indicated that 26 patients had significant coronary artery disease (defined as 70% or more narrowing of luminal diameter) of one vessel, 21 had multivessel disease and 18 had no significant coronary artery disease. Although the exercise left ventricular ejection fraction was significantly higher in patients with no coronary artery disease than in patients with one or multivessel disease (probability [p] less than 0.001), there was considerable overlap among the three groups. With the scoring system, a good correlation was found between the coronary artery disease score and the exercise left ventricular ejection fraction (r = -0.70; p less than 0.001). If the exercise heart rate was 130 beats/min or greater or the age of the patient was 50 years or less, an even better correlation was found (r = -0.73 and r = -0.82, respectively). The exercise ejection fraction (but not the change in ejection fraction, end-diastolic volume and end-systolic volume from rest to exercise) correlated with the extent of coronary artery disease. The exercise ejection fraction is the most important exercise variable that correlates with the extent of coronary artery disease when the latter is assessed quantitatively by a scoring system rather than the conventional method of reporting coronary angiograms. Young age and greater exercise heart rate strengthened the correlation. The change in ejection fraction from rest to exercise is useful in the diagnosis of coronary artery disease, but it was the absolute level of exercise ejection fraction that predicted the extent of disease.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

DePace NL,Iskandrian AS,Hakki AH,Kane SA,Segal BL

doi

10.1016/s0735-1097(83)80101-6

subject

Has Abstract

pub_date

1983-04-01 00:00:00

pages

1002-10

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(83)80101-6

journal_volume

pub_type

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Value of left ventricular ejection fraction during exercise in predicting the extent of coronary artery disease.