Skip Navigation

European Heart Journal 1989 10(11):991-997;
Copyright © 1989 by the European Society of Cardiology.
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by BUGIARDINI, R.
Right arrow Articles by PUDDU, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by BUGIARDINI, R.
Right arrow Articles by PUDDU, P.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 1989 The European Society of Cardiology

ST/HR slope during prostacyclin treatment: An improved method to identify patients with advanced coronary artery disease

R. BUGIARDINI, A. BORGHI, G. MORGAGNI, A. POZZATI, F. OTTANI, F. A. NICOLINI and P. PUDDU

Institute of Patologia Medica and Coronary Care Unit, University of Bologna Italy

Received 14 October 1988; revised 10 April 1989; .

Address for reprints: Dr Raffaele Bugiardini, Istituto di Patologia Medica, Ospedale S. Orsola—USL 28, Via Massarenti 9, 40138 Bologna, Italy.

Abstract

Constriction of atherosclerotic coronary segments during exercise may further reduce coronary flow reserve in patients with coronary artery disease. This could influence the linear regression analysis of the heart rate-related changes in ST-segment depression (ST/HR slope) thereby limiting the accuracy of this method in identifying the severity of the disease.

To test this hypothesis, the exercise related ST/HR slopes on placebo were compared with those obtained during coronary vasodilation induced by a prostacyclin analogue (iloprost 6 ng kg–1 min–1) in 42 anginal patients with documented coronary artery disease. In seven of these, the same protocol was repeated during right heart catheterization.

The overall diagnostic accuracy of the ST/HR slope on iloprost was better than on placebo in patients with advanced coronary artery disease. This was due mainly to a consistent rightward shift of the ST/HRslope in patients with one- and two-vessel, but not three-vessel disease or left main stem disease. The reason for the greater effects of iloprost on ST/HR slopes in patients with a lesser degree of atherosclerosis remains unclear. However, coronary blood flow was higher during drug infusion, which suggests that iloprost may prevent the occurrence of dynamic coronary events able to reduce the maximum coronary flow reserve during exertion. This mechanism may be predominant in patients with minor coronary artery disease.

Key Words: Coronary artery disease • ST/HR slope • prostacyclin


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.