American Journal of Cardiology
Volume 82, Issue 1 , Page 109 , 1 July 1998

Improved myocardial ischemia detection by combined physical and mental stress testing

  • PatrickR Hunziker, MD

      Affiliations

    • Division of Cardiology, University Hospital, Basel, Switzerland
    • Corresponding Author InformationDr. Hunziker’s address is: Division of Cardiology, University Hospital, Petersgraben 5, 4031 Basel, Switzerland
    • ,
  • Christoph Gradel, MD

      Affiliations

    • Division of Cardiology, University Hospital, Basel, Switzerland
    • ,
  • Jan Müller-Brand, MD

      Affiliations

    • Division of Nuclear Medicine, University Hospital, Basel, Switzerland
    • ,
  • Peter Buser, MD

      Affiliations

    • Division of Cardiology, University Hospital, Basel, Switzerland
    • ,
  • Matthias Pfisterer, MD

      Affiliations

    • Division of Cardiology, University Hospital, Basel, Switzerland

Received 5 December 1997 ,Revised 13 February 1998 ,Accepted 13 February 1998.

References 

  1. Gianrossi R, Detrano R, Mulvihill D, Lehmann K, Dubach P, Mulvihill D, et al. Exercise-induced ST depression in the diagnosis of coronary artery disease (a meta-analysis). Circulation. 1989;80:89–98
  2. Pfisterer M, Slutsky RA, Schuler G, Ricci DR, Swanson SS, Gordon DG, et al. Profiles of radionuclide left ventricular ejection fraction changes induced by supine bicycle exercise in normals and patients with coronary artery disease. Cathet Cardiovasc Diagn. 1979;5:305–317
  3. Ryan T, Segar DS, Sawada SG, Berkovitz KE, Whang D, Dohan AM, et al. Detection of coronary artery disease with upright bicycle echocardiography. J Am Soc Echocardiogr. 1993;6:186–191
  4. Zaret BL, Strauss HW, Martin ND, Wells HP, Flamm MD. Noninvasive regional perfusion with radioactive potassium. Study of patients at rest, with exercise and during angina pectoris. N Engl J Med. 1973;288:809–812
  5. Hachamovitch R, Bermand DS, Kiat H, Cohen I, Cabico JA, Friedman J, et al. Exercise myocardial perfusion SPECT in patients without known coronary artery disease (incremental prognostic value and use in risk stratification). Circulation. 1996;93:905–914
  6. Villella A, Maggioni AP, Villela M, Giordano A, Turazza FM, Santoro E, et al. Prognostic significance of maximal exercise testing after myocardial infarction treated with thrombolytic agents (the GISSI-2 database). Lancet. 1995;346:523–529
  7. Volpi A, De Vita C, Franzosi MG, Geraci E, Maggioni AP, Mauri F, et al. Determinants of 6-month mortality in survivors of myocardial infarction after thrombolysis. Results of the GISSI-2 database. Circulation. 1993;88:416–429
  8. McNeill AJ, Fioretti PM, El-Said EM, Salustri A, Forster T, Roelandt JR. Enhanced sensitivity for detection of coronary artery disease by addition of atropine to dobutamine stress echocardiography. Am J Cardiol. 1992;70:41–46
  9. Borg G, Noble GJ. Perceived exertion. In:  Wilmore JH editors. Exercise and Sports Sciences Review. 2:London: Academic Press; 1974;p. 131–153
  10. Pfisterer M, Glaus L, Burkart F. Comparative effects of nitroglycerine, nifedipine and metoprolol on regional left ventricular function in patients with single vessel coronary disease. Circulation. 1983;67:291–301
  11. Massardo T, Gal RA, Grenier RP, Schmidt DH, Port SC. Left ventricular volume calculation using a count based ratio method applied to multigated radionuclide angiography. J Nucl Med. 1990;31:450–456. \[erratum 1990
  12. Rozanski , Bairy CN, Krantz DS, Friedman J, Resser KJ, Morell M, et al. Mental stress and the induction of silent myocardial ischemia in patients with coronary artery disease. N Engl J Med. 1988;318:1005–1012
  13. Deanfield JE, Shea M, Kensett M, Horlock P, Wilson RA, de Landsheere CM, et al. Silent myocardial ischemia due to mental stress. Lancet. 1984;2:1001–1005
  14. Legault SE, Freeman MR, Langer A, Armstrong PW. Pathophysiology and time course of silent myocardial ischaemia during mental stress (clinical, anatomical, and physiological correlates). Br Heart J. 1995;73:242–249
  15. Saitoh M, Yanagawa T, Kondoh T, Miyakoda H, Kotake H, Mashiba H. Neurohumoral factor responses to mental (arithmetic) stress and dynamic exercise in normal subjects. Intern Med. 1995;34:618–622
  16. Jiang W, Babyak M, Krantz DS, Waugh RA, Coleman RE, Hanson MM, et al. Mental stress–induced myocardial ischemia and cardiac events. JAMA. 1996;275:1651–1656
  17. Goldberg AD, Becker LC, Bonsall R, Cohen JD, Ketterer MW, Kaufman PG, et al  Ischemic, hemodynamic, and neurohormonal responses to mental and exercise stress. Experience from the Psychophysiological Investigations of Myocardial Ischemia Study (PIMI). Circulation. 1996;94:2402–2409
  18. Schiffer F, Hartley LH, Schulman CL, Abelmann WH. Evidence for emotionally induced coronary arterial spasm in patients with angina pectoris. Br Heart J. 1980;44:62–66
  19. Dakak N, Quyyumi AA, Eisenhofer G, Goldstein DS, Cannon RO. Sympathetically mediated effects of mental stress on the cardiac microcirculation of patients with coronary artery disease. Am J Cardiol. 1995;76:125–130
  20. Papademetriou V, Gottdiener JS, Kop WJ, Howell RH, Krantz DS. Transient coronary occlusion with mental stress. Am Heart J 1996:132:1299–1301.

PII: S0002-9149(98)00229-X

American Journal of Cardiology
Volume 82, Issue 1 , Page 109 , 1 July 1998

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