Myocardial ischemia during daily activities: the importance of increased myocardial oxygen demand
- PMID: 1856408
- DOI: 10.1016/0735-1097(91)90593-x
Myocardial ischemia during daily activities: the importance of increased myocardial oxygen demand
Abstract
The role of increased myocardial oxygen demand in the pathophysiology of myocardial ischemia occurring during daily activities was evaluated in 50 patients with coronary artery disease and exercise-induced ST segment depression. Each patient underwent ambulatory electrocardiographic (ECG) monitoring for ST segment shifts during normal daily activities and symptom-limited bicycle exercise testing with continuous ECG monitoring. All 50 patients had ST depression greater than or equal to 0.1 mV during exercise. A total of 241 episodes of ST depression were noted in the ambulatory setting in 31 patients; only 6% of these were accompanied by angina pectoris. Significant (0.1 mV) ST depression during ambulatory monitoring was preceded by a mean increase in heart rate of 27 +/- 12 beats/min. Patients with ischemia during daily activities developed ST depression earlier during exercise (7.9 +/- 4.4 vs. 14.2 +/- 6.4 min, p less than 0.001) and tended to have significant ECG changes at a lower exercise heart rate and rate-pressure product than did those without ST depression during ambulatory monitoring. In the 31 patients with ischemia during daily activities, the mean heart rate associated with ST depression in the ambulatory setting was closely correlated with the heart rate precipitating ECG changes during exercise testing (r = 0.74, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Similar articles
-
Role of increases in heart rate in determining the occurrence and frequency of myocardial ischemia during daily life in patients with stable coronary artery disease.J Am Coll Cardiol. 1992 Nov 1;20(5):1092-8. doi: 10.1016/0735-1097(92)90363-r. J Am Coll Cardiol. 1992. PMID: 1401608
-
Exercise-induced ST-segment depression: imbalance between myocardial oxygen demand and myocardial blood flow.Acta Cardiol. 2000 Feb;55(1):25-31. doi: 10.2143/AC.55.1.2005714. Acta Cardiol. 2000. PMID: 10707755
-
Ambulatory heart rate and ST-segment depression during painful and silent myocardial ischemia in chronic stable angina pectoris.Am J Cardiol. 1987 May 1;59(12):1029-34. doi: 10.1016/0002-9149(87)90843-5. Am J Cardiol. 1987. PMID: 3578043
-
Role of myocardial oxygen demand in the pathogenesis of silent ischemia during daily life.Am J Cardiol. 1992 Nov 16;70(16):19F-24F. doi: 10.1016/0002-9149(92)90185-2. Am J Cardiol. 1992. PMID: 1442597 Review.
-
Heart rate adjustment of ST segment depression and performance of the exercise electrocardiogram: a critical evaluation.J Am Coll Cardiol. 1995 Jun;25(7):1726-35. doi: 10.1016/0735-1097(95)00085-i. J Am Coll Cardiol. 1995. PMID: 7759730 Review.
Cited by
-
Exploring Emotion-Regulation and Autonomic Physiology in Metastatic Breast Cancer Patients: Repression, Suppression, and Restraint of Hostility.Pers Individ Dif. 2008 Jan;44(1):226-237. doi: 10.1016/j.paid.2007.08.002. Pers Individ Dif. 2008. PMID: 18461119 Free PMC article.
-
Dynamic detection and reversal of myocardial ischemia using an artificially intelligent bioelectronic medicine.Sci Adv. 2022 Jan 7;8(1):eabj5473. doi: 10.1126/sciadv.abj5473. Epub 2022 Jan 5. Sci Adv. 2022. PMID: 34985951 Free PMC article.
-
Ivabradine in combination with Beta-blockers in patients with chronic stable angina after percutaneous coronary intervention.Adv Ther. 2015 Feb;32(2):120-37. doi: 10.1007/s12325-015-0182-8. Epub 2015 Feb 17. Adv Ther. 2015. PMID: 25687888 Free PMC article.
-
Rate-Pressure Product is a Novel Predictor for Short- and Long-Term Mortality in Patients with Acute Coronary Syndrome Undergoing Primary PCI/Immediate Invasive Strategy.Clin Interv Aging. 2024 Mar 23;19:571-579. doi: 10.2147/CIA.S449905. eCollection 2024. Clin Interv Aging. 2024. PMID: 38545251 Free PMC article.
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources