Relation of Exercise-induced Ventricular Arrhythmias to Myocardial Viability in Recent Q-wave Myocardial Infarction [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 1997; 25(9): 545-551

Relation of Exercise-induced Ventricular Arrhythmias to Myocardial Viability in Recent Q-wave Myocardial Infarction

Ayşe Emre PINARLI1, Metin GÜRSÜRER1, Mehmet AKSOY1, Dursun ÜNAL1, Turgut SİBER1, Birsen ERSEK1

The association of exercise-induced ventricular arrhythmias with a form of coronary artery disease that carries a worse long-term prognosis and the suppression of these arrhythmias by intravenous nitrates and after successful revascularization suggest that they might be related to viable myocardium in the infarct area. To investigate this, 40 patients with a recent myocardial infaretion (<6 months). were studied by exercise stress testing, coronary angiography and exercise-redistribution-reinjection thallium single-photon emission computed tomography (SPECT). A 20-segment model and a four-point scoring system were used to express thallium uptake in each segment (normal=0 ;severe defect=3). Myocardial segments containing at least 50% of normal Tl-201 uptake on circumferential analysis were considered viable. Regional wall motion on ventriculography was graded semiquantitatively on a 7-segment model (normal=O; dyskinetic=3). Patients were divided into two groups according to the presence (group 1, n= 20) or absence (group 2, n= 20) of exercise-induced ventricular arrhythmias (>10 ventricular ectopic beats/min). Viability was detected in all 20 patients in group 1. but in only 12 patients in group 2 (p<0.01). There was no significant difference in the total number of segments with perfusion defects (8.0 ± 2.9 and 6.4 ± 2.6). The number of segments with nonviable fixed defects were also comparable between the two groups (3.2 ± 2.2 and 3.7 ± 1.5), whereas the number of viable segments (redistribution or ?50% Tl-201 uptake) were higher in group l compared to group 2 (4.8 ± 1.5 vs 2.5 ± 2.5, p<0.01). There was no significant difference in the extent of underlying coronary artery disease, but retrograde filling by collaterals to the infarct-related artery was significantly better in group 1 compared to group 2 (p<0.05). Wall motion abnormality score was also similar (2.9 ± 0.9 and 3.1 ± 1.0) and no patient had a left ventricular aneurysm. These results suggest that ventricular arrhythmias associated with treadmill exercise testing are closely related to viable myocardium in the infarct area in patients with recent myocardial infarction.


How to cite this article
Ayşe Emre PINARLI, Metin GÜRSÜRER, Mehmet AKSOY, Dursun ÜNAL, Turgut SİBER, Birsen ERSEK. Relation of Exercise-induced Ventricular Arrhythmias to Myocardial Viability in Recent Q-wave Myocardial Infarction. Turk Kardiyol Dern Ars. 1997; 25(9): 545-551
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