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• W1533087066 abstract "Right atrial pacing at 140 beats/min for 8 minutes induced an electrocardiographic “ischemic pattern” in 10 patients with normal coronary arteriograms and chest pain usually typical of angina pectoris (group X). The findings were compared with those in 11 patients with demonstrable coronary arterial stenosis who had the same electrocardiographic “ischemic pattern” during pacing (group C). Six patients of group X and eight patients of group C experienced angina during pacing. In addition, a low level of myocardial extraction (less than 10 percent) or production of lactate was observed during pacing in five patients of group X and in seven of group C. Patients of group X showed a significant rise in cardiac index (P <0.05) and left ventricular minute work index (P <0.01), a significant reduction in left ventricular end-diastolic pressure (P <0.01) and unchanged systemic vascular resistance. In contrast, patients of group C showed a significant lowering of cardiac index (P <0.01), unchanged left ventricular minute work index and left ventricular end-diastolic pressure and increased systemic vascular resistance (P <0.001). “Pacing ventricular function curves,” obtained by plotting left ventricular stroke work index against left ventricular enddiastolic pressure, showed marked differences between the two groups. Although the clinical, electrocardiographic and metabolic manifestations were similar in both groups, the mechanism underlying these abnormalities is probably different. Indeed, if patients with the anginal syndrome and normal coronary arteries had myocardial ischemia, they should, like patients with coronary artery disease, exhibit a depressed or unchanged rather than enhanced left ventricular function during pacing stress. Right atrial pacing at 140 beats/min for 8 minutes induced an electrocardiographic “ischemic pattern” in 10 patients with normal coronary arteriograms and chest pain usually typical of angina pectoris (group X). The findings were compared with those in 11 patients with demonstrable coronary arterial stenosis who had the same electrocardiographic “ischemic pattern” during pacing (group C). Six patients of group X and eight patients of group C experienced angina during pacing. In addition, a low level of myocardial extraction (less than 10 percent) or production of lactate was observed during pacing in five patients of group X and in seven of group C. Patients of group X showed a significant rise in cardiac index (P <0.05) and left ventricular minute work index (P <0.01), a significant reduction in left ventricular end-diastolic pressure (P <0.01) and unchanged systemic vascular resistance. In contrast, patients of group C showed a significant lowering of cardiac index (P <0.01), unchanged left ventricular minute work index and left ventricular end-diastolic pressure and increased systemic vascular resistance (P <0.001). “Pacing ventricular function curves,” obtained by plotting left ventricular stroke work index against left ventricular enddiastolic pressure, showed marked differences between the two groups. Although the clinical, electrocardiographic and metabolic manifestations were similar in both groups, the mechanism underlying these abnormalities is probably different. Indeed, if patients with the anginal syndrome and normal coronary arteries had myocardial ischemia, they should, like patients with coronary artery disease, exhibit a depressed or unchanged rather than enhanced left ventricular function during pacing stress." @default.
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• W1533087066 title "Myocardial function during atrial pacing in patients with angina pectoris and normal coronary arteriograms" @default.
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• W1533087066 doi "https://doi.org/10.1016/s0002-9149(73)80130-4" @default.
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