Diagnostic usefulness of the post-exercise systolic blood pressure response for the detection of coronary artery disease in patients with diabetes mellitus

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概要

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• Patients with diabetes mellitus (DM) often have a positive result on exercise testing despite a normal coronary arteriogram, which indicates that exercise-induced ST depression is not always an accurate indicator of the presence of coronary artery disease (CAD) in such patients. The present study evaluated the usefulness of the post-exercise systolic blood pressure (SBP) response for the detection of CAD in 47 consecutive patients with DM. Significant stenotic lesions were detected by angiography in 25 patients; 18 of these had true positive (TP) exercise testing results, and 7 had false negative (FN) results. No significant stenotic lesions were detected in the remaining 22 patients and of these 10 had true negative (TN) exercise testing results, and 12 had false positive (FP) results. The SBP ratio (SBP after 3 min of recovery divided by the SBP at peak exercise) was significantly higher in patients with coronary stenoses than in those without. Analysis of the relative cumulative frequency revealed that a SBP ratio greater than 0.87 was associated with significant stenoses. The sensitivity, specificity, and accuracy of ST change combined with a SBP ratio greater than 0.87 for detecting stenoses in patients with DM were 68%, 82%, and 74%, respectively. These results suggest that calculating the SBP ratio, in combination with monitoring for ST depression, improves the accuracy of treadmill exercise testing for the detection of CAD in patients with DM.

• 社団法人日本循環器学会の論文
• 2000-11-20

著者

• Shimizu Masami

  the Second Department of Internal Medicine, Kanazawa University Hospital

• Yamagishi Masakazu

  Japanese Brugada Multicenter Registry By The Minister Of Health Labour And Welfare National Cardiova

• MABUCHI Hiroshi

  The Second Department of Internal Medicine, School of Medicine, Kanazawa University

• Mabuchi Tomohito

  Department of Cardiology, Fukui Prefectural Hospital

• Yasuda Toshihiko

  Division Of Cardiology Ishikawa Prefectural Hospital

• Yasuda Toshihiko

  Ishikawa Prefectural Central Hospital

• Yasuda Toshihiko

  The Second Department of Internal Medicine, School of Medicine, Kanazawa University, Kanazawa

• Ino Hidekazu

  The Second Department of Internal Medicine, School of Medicine, Kanazawa University, Kanazawa

• Okeie Kazuyasu

  The Second Department of Internal Medicine, School of Medicine, Kanazawa University, Kanazawa

• Yamaguchi Masato

  The Second Department of Internal Medicine, School of Medicine, Kanazawa University, Kanazawa

• Fujino Noboru

  The Second Department of Internal Medicine, School of Medicine, Kanazawa University, Kanazawa

• Fujii Hiroyuki

  The Second Department of Internal Medicine, School of Medicine, Kanazawa University, Kanazawa

• Mabuchi Tomohito

  The Second Department of Internal Medicine, School of Medicine, Kanazawa University, Kanazawa

• Okeie Kazuyasu

  The Second Department Of Internal Medicine School Of Medicine Kanazawa University Kanazawa

• Mabuchi Tomohito

  Department Of Cardiology Fukui Prefectural Hospital

• Fujii Hiroyuki

  Komatsu Municipal Hospital

• Fujita Hiromi

  Ohara General Hospital Fukushima Jpn

• Mabuchi Hiroshi

  The Second Department Of Internal Medicine

• Shimizu Masami

  The Second Department Of Internal Medicine School Of Medicine Kanazawa University

• Yamaguchi Masato

  The Second Department Of Internal Medicine Gifu University School Of Medicine

• Yamagishi Masakazu

  Molecular Genetics Of Cardiovascular Disorders Graduate School Of Medical Science Kanazawa Universit

• Itoh Hideki

  Department Of Emergency And Critical Care Medicine Kanazawa University Hospital

• Mabuchi Tomohito

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Graduate School O

• Shimizu Masami

  The Second Department Of Internal Medicine Kanazawa University Hospital

• INO Hidekazu

  the Second Department of Internal Medicine, School of Medicine, Kanazawa University

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