TY - JOUR
T1 - Hypertensive response to exercise
T2 - A potential cause for new wall motion abnormality in the absence of coronary artery disease
AU - Ha, Jong Won
AU - Juracan, Eldyn M.
AU - Mahoney, Douglas W.
AU - Oh, Jae K.
AU - Shub, Clarence
AU - Seward, James B.
AU - Pellikka, Patricia A.
N1 - Funding Information:
Dr. Ha is the recipient of the Groom’s Scholarship of Mayo Foundation and the Korean Research Foundation Grant (KRF-2000-FA0019), Seoul, Korea.
PY - 2002/1/16
Y1 - 2002/1/16
N2 - OBJECTIVES: We sought to characterize patients with a hypertensive response during exercise echocardiography and its effect on results of the test. BACKGROUND: A hypertensive response to exercise has been shown to cause false-positive results in perfusion imaging, radionuclide angiography and exercise electrocardiography, but its influence on exercise echocardiography has not been reported. METHODS: We identified 548 of 6,686 patients who had coronary angiography within four weeks after exercise echocardiography from 1992 through 1996. Echocardiographic results from 132 patients (24%) with a hypertensive response to exercise, defined as systolic blood pressure (SBP) >220 mm Hg for men and SBP >190 mm Hg for women or as an increase in diastolic blood pressure (DBP) >10 mm Hg or DBP >90 mm Hg during exercise echocardiography, were compared with those from 416 patients without a hypertensive response. RESULTS: Of 132 patients with a hypertensive response to exercise, 108 patients had exercise echocardiographic results positive for ischemia. Of these patients, 24 (22%) were found to have no significant coronary artery disease (CAD). In contrast, of 320 patients with positive exercise echocardiographic results without a hypertensive response, 39 (12%) patients did not have significant CAD. Among the false-positive results, new wall motion abnormalities were extensive in 15 of 24 (63%) hypertensive responders involving >25% of segments compared with 14 of 39 nonhypertensive responders (36%, p = 0.012). CONCLUSIONS: An excessive rise in blood pressure during exercise is associated with a greater likelihood of new or worsening abnormalities with exercise, which may be observed in the absence of angiographically significant coronary artery stenosis.
AB - OBJECTIVES: We sought to characterize patients with a hypertensive response during exercise echocardiography and its effect on results of the test. BACKGROUND: A hypertensive response to exercise has been shown to cause false-positive results in perfusion imaging, radionuclide angiography and exercise electrocardiography, but its influence on exercise echocardiography has not been reported. METHODS: We identified 548 of 6,686 patients who had coronary angiography within four weeks after exercise echocardiography from 1992 through 1996. Echocardiographic results from 132 patients (24%) with a hypertensive response to exercise, defined as systolic blood pressure (SBP) >220 mm Hg for men and SBP >190 mm Hg for women or as an increase in diastolic blood pressure (DBP) >10 mm Hg or DBP >90 mm Hg during exercise echocardiography, were compared with those from 416 patients without a hypertensive response. RESULTS: Of 132 patients with a hypertensive response to exercise, 108 patients had exercise echocardiographic results positive for ischemia. Of these patients, 24 (22%) were found to have no significant coronary artery disease (CAD). In contrast, of 320 patients with positive exercise echocardiographic results without a hypertensive response, 39 (12%) patients did not have significant CAD. Among the false-positive results, new wall motion abnormalities were extensive in 15 of 24 (63%) hypertensive responders involving >25% of segments compared with 14 of 39 nonhypertensive responders (36%, p = 0.012). CONCLUSIONS: An excessive rise in blood pressure during exercise is associated with a greater likelihood of new or worsening abnormalities with exercise, which may be observed in the absence of angiographically significant coronary artery stenosis.
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U2 - 10.1016/S0735-1097(01)01743-0
DO - 10.1016/S0735-1097(01)01743-0
M3 - Article
C2 - 11788226
AN - SCOPUS:0037116568
SN - 0735-1097
VL - 39
SP - 323
EP - 327
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 2
ER -