Hypertensive response to exercise: A potential cause for new wall motion abnormality in the absence of coronary artery disease

Jong Won Ha, Eldyn M. Juracan, Douglas W. Mahoney, Jae Kuen Oh, Clarence Shub, James B. Seward, Patricia Pellikka

Research output: Contribution to journalArticle

58 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)323-327
Number of pages5
JournalJournal of the American College of Cardiology
Volume39
Issue number2
DOIs
StatePublished - Jan 16 2002

Fingerprint

Coronary Artery Disease
Exercise
Blood Pressure
Echocardiography
Radionuclide Angiography
Perfusion Imaging
Coronary Stenosis
Coronary Angiography
Electrocardiography
Ischemia

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Hypertensive response to exercise : A potential cause for new wall motion abnormality in the absence of coronary artery disease. / Ha, Jong Won; Juracan, Eldyn M.; Mahoney, Douglas W.; Oh, Jae Kuen; Shub, Clarence; Seward, James B.; Pellikka, Patricia.

In: Journal of the American College of Cardiology, Vol. 39, No. 2, 16.01.2002, p. 323-327.

Research output: Contribution to journalArticle

@article{a8cf3cdfeef747fbafdbd65e56df3da6,
title = "Hypertensive response to exercise: A potential cause for new wall motion abnormality in the absence of coronary artery disease",
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.",
author = "Ha, {Jong Won} and Juracan, {Eldyn M.} and Mahoney, {Douglas W.} and Oh, {Jae Kuen} and Clarence Shub and Seward, {James B.} and Patricia Pellikka",
year = "2002",
month = "1",
day = "16",
doi = "10.1016/S0735-1097(01)01743-0",
language = "English (US)",
volume = "39",
pages = "323--327",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "2",

}

TY - JOUR

T1 - Hypertensive response to exercise

T2 - A potential cause for new wall motion abnormality in the absence of coronary artery disease

AU - Ha, Jong Won

AU - Juracan, Eldyn M.

AU - Mahoney, Douglas W.

AU - Oh, Jae Kuen

AU - Shub, Clarence

AU - Seward, James B.

AU - Pellikka, Patricia

PY - 2002/1/16

Y1 - 2002/1/16

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=0037116568&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037116568&partnerID=8YFLogxK

U2 - 10.1016/S0735-1097(01)01743-0

DO - 10.1016/S0735-1097(01)01743-0

M3 - Article

C2 - 11788226

AN - SCOPUS:0037116568

VL - 39

SP - 323

EP - 327

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 2

ER -