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Electrocardiographic markers of ischemia during mental stress testing in postinfarction patients : role of body surface mapping

Circulation (New York, N.Y.), 1991, Vol.83 (4), p.II.115-II.127 [Peer Reviewed Journal]

1992 INIST-CNRS ;ISSN: 0009-7322 ;EISSN: 1524-4539 ;CODEN: CIRCAZ

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Title:
Electrocardiographic markers of ischemia during mental stress testing in postinfarction patients : role of body surface mapping
Author: BOSIMINI, E ; GALLI, M ; GUAGLIUMI, G ; GIUBBINI, R ; TAVAZZI, L
Subjects: BETA DECAY RADIOISOTOPES ; BETA-MINUS DECAY RADIOISOTOPES ; Biological and medical sciences ; BIOLOGICAL MARKERS ; BIOLOGICAL STRESS ; BODY ; Cardiology. Vascular system ; CARDIOVASCULAR DISEASES ; CARDIOVASCULAR SYSTEM ; Coronary heart disease ; COUNTING TECHNIQUES ; DAYS LIVING RADIOISOTOPES ; DIAGNOSIS ; DIAGNOSTIC TECHNIQUES ; DIAGRAMS ; DISEASES ; ELECTROCARDIOGRAMS ; ELECTRON CAPTURE RADIOISOTOPES ; EXERCISE ; HEART ; HEAVY NUCLEI ; HOURS LIVING RADIOISOTOPES ; INTERMEDIATE MASS NUCLEI ; ISCHEMIA ; ISOMERIC NUCLEI ; ISOMERIC TRANSITION ISOTOPES ; ISOTOPES ; Medical sciences ; MYOCARDIAL INFARCTION ; NITRILES ; NUCLEI ; ODD-EVEN NUCLEI ; ORGANIC COMPOUNDS ; ORGANIC NITROGEN COMPOUNDS ; ORGANS ; PATIENTS ; RADIOISOTOPE SCANNING ; RADIOISOTOPES ; RADIOLOGY AND NUCLEAR MEDICINE ; SCINTISCANNING ; SECONDS LIVING RADIOISOTOPES ; SENSITIVITY ANALYSIS ; TECHNETIUM 99 ; TECHNETIUM ISOTOPES ; THALLIUM 201 ; THALLIUM ISOTOPES ; VASCULAR DISEASES ; YEARS LIVING RADIOISOTOPES 550601 -- Medicine-- Unsealed Radionuclides in Diagnostics
Is Part Of: Circulation (New York, N.Y.), 1991, Vol.83 (4), p.II.115-II.127
Description: In patients with coronary artery disease, radionuclide investigations have documented a high incidence of mental stress-induced myocardial ischemia in the absence of significant electrocardiographic changes and/or angina. To investigate the causes of the low electrocardiographic sensitivity, we recorded body surface maps during mental arithmetic in 22 normal volunteers and 37 postinfarction patients with residual exercise ischemia. Myocardial perfusion was studied with thallium-201 or technetium-99 (SESTAMIBI) planar scans. In 14 patients, body surface maps were also recorded during atrial pacing at the heart rate values achieved during mental stress. While taking the body surface maps, the area from J point to 80 msec after this point (ST-80) was analyzed by integral maps, difference maps, and departure maps. The body surface mapping criteria for ischemia were a new negative area on the integral maps, a negative potential of more than 2 SD from mean normal values on the difference maps, and a negative departure index of more than 2. Scintigraphy showed asymptomatic myocardial hypoperfusion in 33 patients. Eight patients had significant ST segment depression. The ST-80 integral and difference maps identified 17 ischemic patients. Twenty-four patients presented abnormal departure maps. One patient presented ST depression and abnormal body surface maps without reversible tracer defect. In 14 of 14 patients, atrial pacing did not reproduce the body surface map abnormalities. The analyses of the other electrocardiographic variables showed that in patients with mental stress-induced perfusion defects, only changes of T apex-T offset (aT-eT) interval in Frank leads and changes of maximum negative potential value of aT-eT integral maps significantly differed from those of normal subjects.
Publisher: Hagerstown, MD: Lippincott Williams & Wilkins
Language: English
Identifier: ISSN: 0009-7322
EISSN: 1524-4539
CODEN: CIRCAZ
Source: Geneva Foundation Free Medical Journals at publisher websites

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Electrocardiographic markers of ischemia during mental stress testing in postinfarction patients : role of body surface mapping

1992 INIST-CNRS ;ISSN: 0009-7322 ;EISSN: 1524-4539 ;CODEN: CIRCAZ

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