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dc.contributor.authorSiogas, K.en
dc.contributor.authorPappas, S.en
dc.contributor.authorGraekas, G.en
dc.contributor.authorGoudevenos, J.en
dc.contributor.authorLiapi, G.en
dc.contributor.authorSideris, D. A.en
dc.rightsDefault Licence-
dc.subjectAnalysis of Varianceen
dc.subjectAorta/drug effectsen
dc.subjectBlood Pressure/drug effectsen
dc.subjectChi-Square Distributionen
dc.subjectCoronary Angiographyen
dc.subjectCoronary Disease/*complicationsen
dc.subjectEvaluation Studies as Topicen
dc.subjectHeart Catheterization/adverse effectsen
dc.subjectMetaraminol/*diagnostic useen
dc.subjectMiddle Ageden
dc.subjectStroke Volumeen
dc.subjectVasoconstrictor Agents/*diagnostic useen
dc.subjectVentricular Dysfunction/chemically induceden
dc.subjectVentricular Premature Complexes/*etiologyen
dc.titleSegmental wall motion abnormalities alter vulnerability to ventricular ectopic beats associated with acute increases in aortic pressure in patients with underlying coronary artery diseaseen
heal.type.enJournal articleen
heal.type.elΆρθρο Περιοδικούel
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.abstractOBJECTIVE: To evaluate whether patients with coronary artery disease are susceptible to pressure related ventricular arrhythmias, and if so to identify possible risk factors. DESIGN: Interventional study. METHODS: Metaraminol was given to 43 patients undergoing coronary arteriography for ischaemic heart disease to increase their aortic pressure, provided their systolic blood pressure was < 160 mm Hg and they were in sinus rhythm, without any ventricular ectopic activity (or with fewer than six ventricular ectopic beats a minute) during a five minute control period. RESULTS: During the metaraminol infusion, systolic aortic pressure rose from 131 (15) to 199 (12) mm Hg (mean (SD)). Ventricular ectopy appeared (or ventricular ectopic beats increased by > 100%) in 13/43 patients. Ventricular ectopy was not related to age, sex, presence of hypertension, history of myocardial infarction, use of beta blockers, positive exercise test, number of vessels diseased, or heart rate change during metaraminol infusion. There was a strong relation between the appearance of ventricular arrhythmia and segmental wall motion abnormalities: 1/19 (5.3%, 95% confidence interval 0.1% to 26.0%) without abnormality; 2/12 (16.7%, 2.1% to 48.4%) with hypokinesia; and 10/12 (83.3%, 51.6% to 97.1%) with akinesia or dyskinesia, chi 2 = 22.7, p < 0.001). Ejection fraction was also a significant but not independent risk factor. CONCLUSIONS: Patients with segmental wall motion abnormalities are predisposed to ventricular ectopic beats during an increase in systolic aortic pressure. This could be explained by associated electrophysiological inhomogeneity. The presence of mechanical inhomogeneity, as may occur in postinfarction akinesia or dyskinesia, may affect the aortic pressure above which ventricular arrhythmias appear.en
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