Submaximal exercise testing after acute myocardial infarction: Myocardial scintigraphic and electrocardiographic observations

Coronary Heart Disease Syndromes: Pathophysiology and Clinical Recognition

“…One may also demonstrate reversible wall motion abnormalities by echocardiography, radionuclide ventriculography, or MRI when potent inotropic stimuli, such as dobutamine, dopamine, or paired electrical stimulations, are used, or during low-level exercise 5 to 7 days after MI. [211][212][213][214][215][216][217][218][219][220] Finally, the extent of myocardial scar may be identifi ed by MRI and estimated by a QRS scoring system. 221,221a Evaluation of Ventricular Function Invasive and noninvasive techniques can be used to allow more precise characterization of ventricular function in patients with reduced systemic arterial blood pressure and uncertain LV functional status.…”

Effect of oral propranolol on rest and exercise left ventricular ejection fraction, volumes, and segmental wall motion in patients with angina pectoris. Assessment with equilibrium gated blood pool imaging.

“…Repeat exercise tests after the institution of oral propranolol were performed approximately three to four hours after a dose of propranolol and only after a minimum of three days at a stable dosage schedule. In all but one patient an equivalent or greater workload was achieved on propranolol ( Multigated equilibrium blood pool imaging was performed using in vivo labelling of red blood cells with unlabelled stannous pyrophosphate (New England Nuclear-Pyrolite) before 30 mCi of 99mTc as sodium pertechnetate.11 12 Collection of data was performed with a standard gamma scintillation camera (Ohio Nuclear Series 100) equipped with an all purpose parallel hole collimator and interfaced with a dedicated on-lire computer system (Ohio Nuclear VIP-450). Resting equilibrium gated blood pool scintigrams were obtained in multiple projections including a 350 LAO projection modified to include a 15°caudad angulation of the collimator surface.…”

Invited commentary

“…Radionuclide angiocardiography at rest and exercise can be successfully used for screening patients for CAD, particularly in the moderate to high probability groups [2]. Global LV ejection fraction usually rises in normals during exercise [8][9][10], enddiastolic and stroke volume increase, and end-systolic volume decreases. Jones et al demonstrated convincingly that in patients with significant singlevessel disease, there was an equivalent increase in end-diastolic and stroke volume, so that no change in EF resulted, whereas in patients with multiple-vessel disease, end-diastolic volume increased more than the stroke volume, so that global EF decreased.…”