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July 1984

Left Ventricular Ejection Times During Exercise Testing With Scintigraphy: Their Use in the Detection of Ischemic Heart Disease

Author Affiliations

From the Cardiology Section (Dr Rubler) and Nuclear Medicine Service (Drs Schreiber and Rothschild), New York Veterans Administration Medical Center, and the Departments of Medicine (Dr Rubler) and Physiology (Dr Fisher), New York University School of Medicine (Mr Dobin).

Arch Intern Med. 1984;144(7):1386-1391. doi:10.1001/archinte.1984.00350190070013

• Left ventricular ejection times (LVETs) were obtained in a group of 20 control subjects (group 1) during maximal treadmill exercise testing, using a Bruce protocol, and in conjunction with myocardial scintigraphy. Heart rates (HRs) and LVETs were recorded during standing rest, each minute of exercise, and for eight minutes in the postexercise period. A linear regression equation was constructed and separate correction factors of 1.04×HR+observed LVET (correlation coefficient, -.86) for the exercise period and 0.73× HR + LVET (correlation coefficient, -.71) for the postexercise period were derived. The LVETs were also recorded in 31 subjects with positive ECGs and defects on myocardial scanning with thallous chloride TL201 (group 2) during a similar exercise protocol. Comparison of groups 1 and 2 disclosed that the former had a higher HR and shorter LVET than the latter at peak effort (consonant with the significantly longer duration of exercise achieved by the control subjects). The LVETs in group 1 remained significantly shorter than that of group 2 through the fifth minute postexercise. In the postexercise period, the LVET indexes were significantly shorter in group 1 than group 2 at 1, 3, and 5 minutes. Subjects with presumptive coronary disease (positive ECG and defects on thallium 201 scanning) not only have a decreased exercise tolerance and HR, but after exercise, their ejection times are substantially longer than in normal subjects. This may be attributed to a slower rate of ejection in patients with coronary disease when venous pooling on quiet standing after exercise delivers a smaller volume to the heart. In normal subjects, the lesser volume may be ejected more rapidly.

(Arch Intern Med 1984;144:1386-1391)

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