Abstract
We compared cardiohemodynamic response to dynamic exercise in 32 patients with exercise-induced silent or symptomatic myocardial ischemia. All patients had coronary artery disease without prior myocardial infarction and left ventricular hypertrophy. Patients underwent supine leg-exercise testing and received right heart catheterization. All patients exhibited ischemic ST-segment depression on electrocardiogram during exercise testing. They were classified retrospectively into two groups according to the absence ( n = 10, group 1) or presence ( n = 22, group 2) of chest pain induced by exercise. There was no significant difference between groups in the magnitude of peak ST-segment depression. Pulmonary artery wedge pressure at peak exercise was significantly lower ( p < 0.01), and the cardiac index was significantly higher ( p < 0.01), in group 1 versus group 2. Our results indicate that exercise-induced left ventricular dysfunction is less severe in patients with silent myocardial ischemia than in those with symptomatic ischemia.
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