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Determination of coronary-myocardial reserve by stress echocardiography in patients with programmed pacemaker
Authors:Iskenderov B G  Stepkin V A
Abstract:AIM: To study coronary-myocardial reserve in patients with a programmed pacemaker. MATERIALS AND METHODS: Stress-echocardiography was performed in 64 patients with coronary heart disease (CHD). The stress was induced by a gradual increase in the frequency of electrostimulation (ES) by 10 imp/min from initial 90 imp/min to threshold value which was defined as the frequency threshold of myocardial ischemia induction (FT). RESULTS: Registration of defects in local left ventricular contractility and cardiodynamics in frequent heart ES identified patients with predominant coronary and myocardial failure. Low FT (100-110 imp/min) indicates poor coronary reserve while a considerable rise of the end diastolic pressure in the left ventricle indicates limited myocardial reserve. Positive results of the test in isolated ventricular ES were obtained in 90.9%, in atrial ES in 72.7% of patients. CONCLUSION: As a highly informative and reproducible method, stress echocardiography can be employed for optimization of antianginal therapy in CHD patients with a pacemaker.
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