Exercise stress echocardiography for diagnosis of coronary artery disease in hypertension

A. Maltagliati, M. Muratori, M. Berti, G. Tamborini, E. Tavasci, B. Passaretti, M. Pepi

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Abstract

In hypertension angina pectoris may occur in the absence of angiographically documented coronary disease, as a consequence of a disordered microcirculation. Because of this, the percentage of false positive tests may be high when coronary disease is detected with stress ECG or scintigraphy. In addition, tests may be limited by an abnormal increase in blood pressure during exercise. The aim of this study was to evaluate the accuracy of exercise echocardiography in the detection of coronary artery disease in hypertension and to test whether pharmacological therapy affects test accuracy. Thirty-five primary hypertensives subjected to coronary angiography because of chest pain underwent exercise echocardiography after pharmacological wash out and, one day later, after normalization of blood pressure with nifedipine (10 mg sl). Thirty-five normotensives under going coronary angiography were the control group. Fourteen hypertensives had significant epicardial vessel disease; in the absence of therapy, sensitivity, specificity and diagnostic accuracy of exercise echocardiography were 92, 100 and 97% respectively; after nifedipine, sensitivity was 78%, specificity 100%, diagnostic accuracy 91%. Before therapy, sensitivity, specificity and diagnostic accuracy of exercise ECG were 76, 85, and 80% respectively; after nifedipine, sensitivity was 46%, specificity 95%, diagnostic accuracy 74%. Exercise echocardiography is a method more accurate than exercise ECG for detection of coronary artery disease in hypertension; vasodilator therapy slightly influences exercise echo sensitivity, while specificity is unchanged.

Original languageEnglish
Pages (from-to)305-308
Number of pages4
JournalCardiovascular Imaging
Volume8
Issue number2
Publication statusPublished - 1996

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ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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