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Long-term effect of inducible silent ischaemia on left ventricular systolic function

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Abstract

Silent myocardial ischaemia is readily detected by exercise radionuclide ventriculography in patients with coronary artery disease. In those who remain asymptomatic and event-free, it is not known whether silent ischaemia which is inducibledespite anti-ischaemic medication exerts an insidious detrimental effect on left ventricular function. To study this, 34 medically treated patients (mean age 57; 26 men) underwent prospective measurement of left ventricular ejection fraction (LVEF) during rest and exercise radionuclide ventriculography without interruption of anti-ischaemic medication at baseline and 12 months later.

There was no significant mean (standard deviation, 95% confidence interval) deterioration from baseline to 12 months in LVEF at rest (50% v 49%, SD 5; 95% CI=−3 to+1), peak exercise (44% v 45%, SD 8; 95% CI=−1 to + 4) and the change in LVEF from rest to exercise (−6% v – 4%, SD 7; 95% CI=−1 to + 5).

Thus, in coronary artery disease patients who remain asymptomatic and event-free on medical therapy, silent myocardial ischaemia which is readily inducible at baseline despite medication does not leadper se to deterioration of left ventricular systolic function at rest or exercise over 12 months.

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Authors and Affiliations

  1. Department of Cardiology, St Bartholomew's Hospital, EC1A 7BE, London, UK

    Richard Lim, Lorraine Dyke & Duncan S. Dymond

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  1. Richard Lim
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  2. Lorraine Dyke
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  3. Duncan S. Dymond
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Lim, R., Dyke, L. & Dymond, D.S. Long-term effect of inducible silent ischaemia on left ventricular systolic function. Int J Cardiac Imag 9, 291–296 (1993). https://doi.org/10.1007/BF01137156

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