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Hypertensive Response to Exercise: A Potential Cause for New Wall Motion Abnormality in the Absence of Coronary Artery Disease

Authors
 Jong Won Ha  ;  Eldyn M. Juracan  ;  Douglas W. Mahoney  ;  Jae K. Oh  ;  Clarence Shub  ;  James B. Seward  ;  Patricia A. Pellikka 
Citation
 JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol.39(2) : 323-327, 2002 
Journal Title
 JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 
ISSN
 0735-1097 
Issue Date
2002
MeSH
Aged ; Coronary Angiography ; Echocardiography, Stress* ; Exercise Test ; Female ; Hemodynamics ; Humans ; Hypertension/physiopathology* ; Male ; Middle Aged ; Myocardial Contraction*
Abstract
Objectives We sought to characterize patients with a hypertensive response during exercise echocardiography and its effect on results of the test. Background A hypertensive response to exercise has been shown to cause false-positive results in perfusion imaging, radionuclide angiography and exercise electrocardiography, but its influence on exercise echocardiography has not been reported. Methods We identified 548 of 6,686 patients who had coronary angiography within four weeks after exercise echocardiography from 1992 through 1996. Echocardiographic results from 132 patients (24%) with a hypertensive response to exercise, defined as systolic blood pressure (SBP) >220 mm Hg for men and SBP >190 mm Hg for women or as an increase in diastolic blood pressure (DBP) >10 mm Hg or DBP >90 mm Hg during exercise echocardiography, were compared with those from 416 patients without a hypertensive response. Results Of 132 patients with a hypertensive response to exercise, 108 patients had exercise echocardiographic results positive for ischemia. Of these patients, 24 (22%) were found to have no significant coronary artery disease (CAD). In contrast, of 320 patients with positive exercise echocardiographic results without a hypertensive response, 39 (12%) patients did not have significant CAD. Among the false-positive results, new wall motion abnormalities were extensive in 15 of 24 (63%) hypertensive responders involving >25% of segments compared with 14 of 39 nonhypertensive responders (36%, p = 0.012). Conclusions An excessive rise in blood pressure during exercise is associated with a greater likelihood of new or worsening abnormalities with exercise, which may be observed in the absence of angiographically significant coronary artery stenosis.
Files in This Item:
T200208939.pdf Download
DOI
10.1016/S0735-1097(01)01743-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/144309
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