Abnormal postexercise systolic blood pressure response is a good indicator of impaired left ventricular filling during supine cycle ergometer exercise in patients with coronary artery disease.
Year: 1993
Type: article
Study design: Observational Study
Abstract: To determine whether the postexercise systolic blood pressure (SBP) response is a useful marker of left ventricular filling abnormalities, supine leg exercise testing was conducted in 14 control subjects and 70 patients with coronary artery disease (CAD). An abnormal postexercise SBP response (the ratio of SBP after 3 min of recovery to the peak exercise SBP) was defined as 0.85 or more, which represented the cutoff point with the highest sensitivity and specificity for prediction of pulmonary artery wedge pressure (PAWP) of at least 20 mmHg at peak exercise in CAD patients. There was a significant difference between the SBP ratios of the two groups (Control, 0.72±0.05; CAD, 0.86±0.13; p<0.01). There was no significant difference between the PAWP of the two groups at rest, but the PAWP at peak exercise was significantly higher in the CAD group (20.2±8.9 mmHg) than in the control group (11.5±4.0 mmHg)(p<0.01). PAWP at peak exercise was ⪈ 20 mmHg in 35 (50%) of the 70 CAD subjects. The SBP ratio was significantly correlated with PAWP at peak exercise (r=0.67, p<0.01) in the CAD group, but not in the control group. An SBP ratio of ⪈ 0.85 showed a sensitivity of 80% and a specificity of 80% for predicting a peak exercise PAWP of ⪈ 20 mmHg in CAD patients. After the administration of a calcium channel blocker, the SBP ratio showed a sensitivity of 80% and a specificity of 95% in the CAD group (n=25), and was significantly correlated with the PAWP at peak exercise (n=25, r=0.69, p<0.01). These observations indicate that the SBP ratio is a good indicator of exercise-induced impairment of left ventricular filling dynamics during supine leg exercise.
DOI: 10.1253/jcj.57.480
Institutions: Nagoya University Hospital, Nagoya University
Language: English
Subfield: Physiology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2014282948