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Biomedical subjects

J E Pescarmona

Publications and source records attributed to J E Pescarmona.

3 recordsLinked to original sources

Objective evidence of occult myocardial dysfunction in patients with frequent ventricular ectopy without clinically apparent heart disease.

Eighteen asymptomatic persons without apparent cardiac disease were incidentally discovered to have frequent ventricular ectopic activity (VEA) (more than a mean of 100 b/hr during 24-hour ambulatory ECG examination) and were found by cardiac catheterization to have normal coronary arteriograms. Thirteen persons (72%) also demonstrated complex (multiform or repetitive patterns) VEA and eight persons were found to have undiagnosed hypertension. Examination of left ventricular (LV) angiographic and hemodynamic data of these persons showed elevated LV end-systolic volume index in 10 persons (56%), elevated LV and end-diastolic volume index in 12 persons (67%) and elevated LV end-diastolic pressure in 11 persons (61%). Although ejection fractions of all but three persons were normal, impaired myocardial contractility, as measured by decreased mean velocity of circumferential fiber shortening (less than 1.0 circ/sec), was found in 10 persons (56%). Abnormalities of LV function were more prevalent in persons with higher mean frequencies of VEA (more than 300 b/hr), but did not seem related to the presence of complex VEA. Etiologic mechanisms of the frequent and complex VEA could not be defined. We conclude that subclinical evidence of myocardial dysfunction is present in some persons without apparent cardiac disease who have frequent VEA as evidence by subtle abnormalities of increased LV volumes and end-diastolic pressure and decreased mean velocity of myocardial circumferential fiber shortening.

Adult↗

Coronary artery status of apparently healthy subjects with frequent and complex ventricular ectopy.

Twenty-five subjects from a cohort of 62 asymptomatic, apparently healthy subjects incidentally discovered to have frequent and complex ventricular ectopy were studied with cardiac catheterization and coronary angiography. Fourteen had normal coronary arteries, five noncritical coronary artery disease (less than 50% luminal narrowing), and six significant coronary artery disease (greater than or equal to 50% luminal narrowing). Slightly elevated left ventricular end diastolic pressures were found in all subject subgroups. Characteristics of the ventricular ectopy detected by maximal exercise testing or 24-hour Holter ambulatory electrocardiography did not differentiate those subjects with coronary artery disease from those with normal coronary arteries. This study documents that a minority of apparently healthy subjects with frequent and complex ventricular arrhythmia have significant coronary artery disease and supports a conservative approach to the management of such patients.

Adult↗

Ventricular arrhythmia 24 hours before and after maximal treadmill testing.

To determine if maximal exercise treadmill testing influences the occurence of ventricular arrhythmia in the hours after exercise, 45 myocardial infarction and 22 angina pectoris patients (New York Heart Association Class I-II), and 23 normal subjects were examined with 24-hour ambulatory electrocardiographic Holter recordings before and after exercise testing. Comparison of qualitative and quantitative ventricular arrhythmia detected during identical chronological two-, four-, and 20- or more hour periods, before and after exercise testing in each patient, revealed no statistically significant difference in any patient group. The prevalence of ventricular ectopy in 80 per cent of ischemic heart disease patients and 30 per cent of normal subjects as detected by 24-hour Holter recordings was similar to previous studies. It is concluded that in ambulatory ischemic heart disease patients (New York Heart Association Class I-II) and normal subjects, maximal treadmill testing does not significantly affect the occurrence of ventricular arrhythmia in the hours after exercise.

Angina Pectoris↗