Showing papers by "Alan Rozanski published in 2002"
TL;DR: Peripheral artery tonometry may be useful for improving the diagnosis of exercise-induced myocardial ischemia by both enhancing the sensitivity without impairing the specificity and increasing the percentage of definitive test results.
22 citations
TL;DR: P the presence of abnormal peripheral vascular function during exercise could identify patients with more functionally severe coronary artery disease (CAD) and if so, such patients could be expected to have a greater magnitude of exercise-induced ischemia.
Abstract: P the presence of abnormal peripheral vascular function during exercise could identify patients with more functionally severe coronary artery disease (CAD). If so, such patients could be expected to have a greater magnitude of exercise-induced ischemia. To test this hypothesis, we evaluated the degree of correlation between the peripheral pulse volume response to exercise and the magnitude of exerciseinduced myocardial hypoperfusion among patients referred for clinical radioisotope imaging.
6 citations
TL;DR: The left ventricular dysfunction is commonly due to hypertension, valvular heart disease, or hibernating myocardium, and in the absence of a prior history of myocardial infarction.
Abstract: Summary Background:In the absence of a prior history of myocardial infarction (MI), left ventricular (LV) dysfunction is commonly due to hypertension, valvular heart disease, or hibernating myocardium. Hypothesis:Since technetium-99m sestamibi gated singlephoton emission computed tomography (SPECT) may be used to determine both stress/rest myocardial perfusion and resting LV function, we attempted to evaluate the ability of gated SPECT imaging to detect occult LV dysfunction. Methods:We evaluated the ability of this technique to detect occult LV dysfunction among 179 patients without history MI and angiographically documented coronary artery disease (CAD). All patients underwent both gated SPECT and cardiac catheterization within a 6-month time period. Left ventricular volume and ejection fraction (EF) values were determined according to a previously validated technique using Simpson’s rule. Normal limit values for LV volumes and EF were derived from a control population of 93 patients with normal coronary angiograms. Results: Based on normal limit-derived criteria, 15% of the CAD study cohort had occult LV dysfunction (>2 standard deviations below gender-specific normal limit means for LVEF). Mean LV end-diastolic volume index (EDVi) was significantly increased (p < 0.05) and LVEF decreased (p < 0.05) in patients with triple-vessel CAD. End-diastolic volume index was also increased in the cohort of patients with both hypertension and LV hypertrophy (LVH) (p < 0.05). However, multivariate logistic regression analysis revealed that only CAD extent, but not hypertension or LVH, was a significant predictor of occult LV dysfunction (p = 0.009). Conclusion: Occult LV dysfunction can be detected in patients with CAD by gating technetium-99m sestamibi SPECT studies, and its presence may signify the presence of extensive CAD.
2 citations