To measure the response of left and right ventricular ejection fraction and wall motion to exercise in eighteen patients with angiogl’aphically documented coronary artery disease (CAD) and in twenty-two patients with...To measure the response of left and right ventricular ejection fraction and wall motion to exercise in eighteen patients with angiogl’aphically documented coronary artery disease (CAD) and in twenty-two patients with angiographicallynormal coronary arteries using ultrafast computed tomography(UFCT). Methods: Angiography and UFCT exercise cine studieswere performed for the evaluation of chest pain in all 40 cases, including 18 CAD patients and 22 patients with normal coronary arteries. Results: Of the 18 patients with CAD, 14(78% ) had a≥5% decrease in left ventricular ejection fraction (LVEF) duringexercise by UFCT (P< 0 .001), and 14 (78%) had an abnormal response in left ventricular wall motion during exercise, (aworsened or newly-developed reginal RV wall motion abnormality (RVWMA)) during exercise. In the 22 normal patients, onlyone had a decrease in LVEF > 5%; none had an abnormal response in LV wall motion during peak exercise or a RVWMA at restor during stress. Using a decrease of ≥5 % in LVEF or a LVWMA or RVWMA during stress as a criterion for identifying patientswith CAD, the accuracy was 88% (35/40) with LVEF, 90% (36/40) with LVWMA, and 92% (37/40) with a combination ofLVEF, LVWMA and RVWMA. The sensitivity of RVWMA alone in detecting right coronary artery disease (RCAD) was 60%(6/10) and the specificity was 78% (7/9). Conclusion: Our study suggests that exercise-UFCT appears to be a useful tool for thedetection of CAD in patients with chest pain. The abnormal response of LVEF and exercise-induced LVWMA and RVWMA as determined by UFCT were important predictors CAD. Both LVWMA and RVWMA of important value in identifying patientswith CAN from those with normal coronary arteries, as is RVWMA in defining the existence of RCAD in patients with CAD.展开更多
文摘To measure the response of left and right ventricular ejection fraction and wall motion to exercise in eighteen patients with angiogl’aphically documented coronary artery disease (CAD) and in twenty-two patients with angiographicallynormal coronary arteries using ultrafast computed tomography(UFCT). Methods: Angiography and UFCT exercise cine studieswere performed for the evaluation of chest pain in all 40 cases, including 18 CAD patients and 22 patients with normal coronary arteries. Results: Of the 18 patients with CAD, 14(78% ) had a≥5% decrease in left ventricular ejection fraction (LVEF) duringexercise by UFCT (P< 0 .001), and 14 (78%) had an abnormal response in left ventricular wall motion during exercise, (aworsened or newly-developed reginal RV wall motion abnormality (RVWMA)) during exercise. In the 22 normal patients, onlyone had a decrease in LVEF > 5%; none had an abnormal response in LV wall motion during peak exercise or a RVWMA at restor during stress. Using a decrease of ≥5 % in LVEF or a LVWMA or RVWMA during stress as a criterion for identifying patientswith CAD, the accuracy was 88% (35/40) with LVEF, 90% (36/40) with LVWMA, and 92% (37/40) with a combination ofLVEF, LVWMA and RVWMA. The sensitivity of RVWMA alone in detecting right coronary artery disease (RCAD) was 60%(6/10) and the specificity was 78% (7/9). Conclusion: Our study suggests that exercise-UFCT appears to be a useful tool for thedetection of CAD in patients with chest pain. The abnormal response of LVEF and exercise-induced LVWMA and RVWMA as determined by UFCT were important predictors CAD. Both LVWMA and RVWMA of important value in identifying patientswith CAN from those with normal coronary arteries, as is RVWMA in defining the existence of RCAD in patients with CAD.
