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• W2091708712 abstract "A 67-year-old female with a history of angina was admitted for progressively increasing exertional precordial pain. There was no history of a prior myocardial infarct. A chest x-ray showed slight cardiomegaly. An electrocardiograph (EKG) showed nonspecific ST-T wave changes in the lateral wall. A gated cardiac blood pool scintiscan that used Tc-99m labeled red cells revealed normal ventricular function and a normal sized left ventricle. The resting left ventricular ejection fraction in the supine legs-up position was 63% and normal contractility was seen (Fig. 1). The patient underwent six minutes of supine bicycle ergometric exercise, reaching 85% of the target heart rate. Exercise was terminated because of chest pain. Repeat imaging at peak exercise demonstrates a decrease in the left ventricular ejection fraction (LVEF) to 48% (Fig. 2). The left ventricle enlarged with an increase in the left ventricular end-diastolic volume. Hypokinesis of the septum developed which was not noted on the rest study. Selective coronary cineangiogram demonstrated a 90% narrowing of the left anterior descending coronary artery at its origin and an area of marked narrowing of the marginal branch of the left circumflex. A contrast left ventriculogram showed normal contractility and normal ejection fraction. The patient underwent aortocoronary bypass grafts to the left anterior descending and circumflex coronary arteries. Borer et al ~ first described the left ventricular response to exercise by using multiple gated equilibrium blood pool scintigraphy. In their initial work, all normal patients developed an increase in the LVEF of at least 7%, whereas all the patients with coronary artery disease either had a decrease or no change in LVEF. In addition, regional wall abnormalities were seen in all patients with coronary artery disease. Although initially the fall in LVEF with exercise or development of abnormal areas of contractility were thought specific for coronary artery disease (CAD), more extensive work has shown that many other conditions can cause these findings, including aortic stenosis, 2 aortic regurgitation? mitral regurgitation, 4 mitral valve prolapse, 5 chronic iron overload, 6 and in normal elderly patients] Technical factors in the performance of the studies are also of major importance in obtaining" @default.
• W2091708712 created "2016-06-24" @default.
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• W2091708712 date "1983-07-01" @default.
• W2091708712 modified "2023-09-27" @default.
• W2091708712 title "Cardiac imaging—Decrease in the left ventricular ejection fraction after exercise" @default.
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• W2091708712 doi "https://doi.org/10.1016/s0001-2998(83)80023-3" @default.
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