Prolonged impairment of regional contractile function after resolution of exercise-induced angina

Evidence of myocardial stunning in patients with coronary artery disease

Giuseppe Ambrosio, Sandro Betocchi, Leonardo Pace, Maria Angela Losi, Pasquale Perrone-Filardi, Andrea Soricelli, Federico Piscione, Jean Taube, Fiorenzo Squame, Marco Salvatore, James L. Weiss, Massimo Chiariello

Research output: Contribution to journalArticle

174 Citations (Scopus)

Abstract

Background: Delayed recovery of contractile function in spite of normal perfusion (ie, 'stunning') has been described in animal models of exercise- induced myocardial ischemia. Therefore, we investigated whether stunning may result from effort angina in patients. Methods and Results: Patients with coronary artery disease underwent exercise testing combined with quantitative measurements of contractile function for up to 240 minutes after exercise determined by either measurement of regional ejection fraction (99mTc radionuclide angiograpy; n=17, group A) or computer-assisted measurement of systolic wall thickening (n=14, group B). In the latter group, myocardial perfusion was also evaluated by 99mTc-sestamibi tomographic imaging. Angina induced marked contractile dysfunction. Hemodynamic and ECG changes brought about by ischemia were promptly normalized. Furthermore, no perfusion defects could be detected in group B patients 30 minutes after exercise, yet contractile function remained impaired well after cessation of exercise. Thirty minutes into recovery, regional ejection function of previously ischemic areas was still 82.6±4.6% of baseline in group A (P

Original languageEnglish
Pages (from-to)2455-2464
Number of pages10
JournalCirculation
Volume94
Issue number10
Publication statusPublished - 1996

Fingerprint

Myocardial Stunning
Coronary Artery Disease
Exercise
Perfusion
Technetium Tc 99m Sestamibi
Recovery of Function
Radioisotopes
Myocardial Ischemia
Electrocardiography
Ischemia
Animal Models
Hemodynamics

Keywords

  • angina
  • coronary disease
  • exercise
  • stunning, myocardial

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Prolonged impairment of regional contractile function after resolution of exercise-induced angina : Evidence of myocardial stunning in patients with coronary artery disease. / Ambrosio, Giuseppe; Betocchi, Sandro; Pace, Leonardo; Losi, Maria Angela; Perrone-Filardi, Pasquale; Soricelli, Andrea; Piscione, Federico; Taube, Jean; Squame, Fiorenzo; Salvatore, Marco; Weiss, James L.; Chiariello, Massimo.

In: Circulation, Vol. 94, No. 10, 1996, p. 2455-2464.

Research output: Contribution to journalArticle

Ambrosio, G, Betocchi, S, Pace, L, Losi, MA, Perrone-Filardi, P, Soricelli, A, Piscione, F, Taube, J, Squame, F, Salvatore, M, Weiss, JL & Chiariello, M 1996, 'Prolonged impairment of regional contractile function after resolution of exercise-induced angina: Evidence of myocardial stunning in patients with coronary artery disease', Circulation, vol. 94, no. 10, pp. 2455-2464.
Ambrosio, Giuseppe ; Betocchi, Sandro ; Pace, Leonardo ; Losi, Maria Angela ; Perrone-Filardi, Pasquale ; Soricelli, Andrea ; Piscione, Federico ; Taube, Jean ; Squame, Fiorenzo ; Salvatore, Marco ; Weiss, James L. ; Chiariello, Massimo. / Prolonged impairment of regional contractile function after resolution of exercise-induced angina : Evidence of myocardial stunning in patients with coronary artery disease. In: Circulation. 1996 ; Vol. 94, No. 10. pp. 2455-2464.
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