VARIOUS TREADMILL TEST PARAMETERS PREDICTING NORMAL CORONARY ANATOMY ON CORONARY ANGIOGRAPHY
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 40
Abstract
BACKGROUND Patients with cardiac Syndrome X defined as typical chest pain associated with electrocardiographic changes suggestive of transient myocardial ischaemia, despite normal coronary angiograms, constitutes diagnostic and therapeutic challenges. Syndrome X is not a “rare syndrome”, as up to 30% of patients undergoing diagnostic angiography for the assessment of typical chest pain are found not to have obstructive coronary artery disease. Various mechanisms were explained for inducible ischaemia in Syndrome X population. One of hypothesis that ischaemia at watershed zone of two coronary vessels is one of contributory factors for myocardial ischaemia. In this study we define various TMT parameters which predict normal coronary angiogram in TMT positive population. MATERIALS AND METHODS It was a prospective study of population who was positive for myocardial ischaemia in treadmill test which were taken for coronary angiography. Various TMT parameters was studies in population having normal coronary angiography and population having significant coronary artery diseases. RESULTS 200 participants who were taken for coronary angiography based on positive myocardial ischaemia, 70 were having normal coronary angiography called Syndrome X and 130 were having significant coronary artery disease (CAD). Treadmill parameters like Duke Treadmill Score (DTS) were -2 in Syndrome X group and -11 in CAD group, Average MET at which ST /T abnormality started were 6.3 in Syndrome X group and 3.2 in CAD group, ST–HR index were 6.6 in Syndrome X and 21.2 in CAD group. Reasons for termination were nonspecific complain in 74.28% in Syndrome X group and 13.84% in CAD group. Type II LAD were present in 28.57% in Syndrome X group and 16.15% in CAD group. CONCLUSION We found that patients in cardiac Syndrome X group were having favourable TMT parameters like greater METS achieved, lesser DTS, ST-HR Index and appearance of ST-T wave abnormalities at grater METS or HR. Further, most of these patients were having type 2 LAD, creating LV apex as a relatively ischaemic zone.
Authors and Affiliations
Ramanand Prasad Sinha, Deepesh Agrawal, Bansal D. P
Keywords
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- EP ID EP575390
- DOI 10.18410/jebmh/2018/576
- Views 91
- Downloads 0
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