Insensitivity of the cold pressor stimulation test for the diagnosis of coronary artery disease

Publication Description
Cold pressor stimulation (CPS) was compared with supine bicycle exercise during radionuclide ventriculography as a procedure for diagnosing coronary artery disease (CAD). Thirty patients were studied. In the 18 patients with angiographically proved CAD, left ventricular ejection fraction (LVEF) decreased a mean of 5.0 +/- 1.0 ejection fraction units (+/- SEM) in response to CPS. Only two patients developed a new wall motion abnormality. In response to maximal supine exercise, the CAD group showed a mean decrease in LVEF from rest of 1.9 +/- 1.1%. Nine patients developed an exercise-induced wall motion abnormality. In the 12 patients with angiographically proved normal coronary arteries, LVEF decreased a mean of 5.8 +/- 1.3 units in response to CPS and increased a mean of 9.2 +/- 1.2% in response to exercise. Thus, the LVEF response to CPS was not significantly different in the CAD and normal groups (5.0 +/- 1.0 vs 5.8 +/- 1.3, NS). These same patients demonstrated the expected difference in LVEF response to exercise. We conclude that CPS produces similar changes in LVEF in patients with and without CAD, and therefore is not useful in diagnosing ischemic heart disease.

Primary Author
Wasserman,A. G.
Reiss,L.
Katz,R. J.
Leiboff,R.
Cleary,P.
Varma,V. M.
Reba,R. C.
Ross,A. M.

Volume
67

Issue
6

Start Page
1189

Other Pages
1193

URL
https://www.ncbi.nlm.nih.gov/pubmed/6303621

PMID
6303621



Reference Type
Journal Article

Periodical Full
Circulation

Publication Year
1983

Publication Date
Jun

Place of Publication
United States

ISSN/ISBN
0009-7322

Document Object Index
10.1161/01.CIR.67.6.1189