scholarly journals The relationship between coronary artery disease and hs-troponin T changing during exercise stress test

2021 ◽  
Author(s):  
İsmail GÜRBAK ◽  
Musatafa Tarık AĞAÇ ◽  
Şükrü ÇELİK
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Troponin T ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Artery Disease ◽  
The Relationship

Hemodynamic Characteristics of Patients with Coronary Artery Disease Presenting False-Negative Exercise Stress Test

Angiology ◽  
1992 ◽  
Vol 43 (6) ◽  
pp. 506-511 ◽  
Author(s):  
Michihito Sekiya ◽  
Makoto Suzuki ◽  
Yasushi Fujiwara ◽  
Takumi Sumimoto ◽  
Mareomi Hamada ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stress Test ◽  
False Negative ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Hemodynamic Characteristics ◽  
Artery Disease

Recent advances in the role of the adenosinergic system in coronary artery disease

2020 ◽  
Author(s):  
Franck Paganelli ◽  
Marine Gaudry ◽  
Jean Ruf ◽  
Régis Guieu
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Tissue Hypoxia ◽  
Exercise Stress ◽  
Fractional Flow ◽  
Coronary Syndrome ◽  
Flow Reserve ◽  
Artery Disease

Abstract Adenosine is an endogenous nucleoside that plays a major role in the physiology and physiopathology of the coronary artery system, mainly by activating its A2A receptors (A2AR). Adenosine is released by myocardial, endothelial, and immune cells during hypoxia, ischaemia, or inflammation, each condition being present in coronary artery disease (CAD). While activation of A2AR improves coronary blood circulation and leads to anti-inflammatory effects, down-regulation of A2AR has many deleterious effects during CAD. A decrease in the level and/or activity of A2AR leads to: (i) lack of vasodilation, which decreases blood flow, leading to a decrease in myocardial oxygenation and tissue hypoxia; (ii) an increase in the immune response, favouring inflammation; and (iii) platelet aggregation, which therefore participates, in part, in the formation of a fibrin-platelet thrombus after the rupture or erosion of the plaque, leading to the occurrence of acute coronary syndrome. Inflammation contributes to the development of atherosclerosis, leading to myocardial ischaemia, which in turn leads to tissue hypoxia. Therefore, a vicious circle is created that maintains and aggravates CAD. In some cases, studying the adenosinergic profile can help assess the severity of CAD. In fact, inducible ischaemia in CAD patients, as assessed by exercise stress test or fractional flow reserve, is associated with the presence of a reserve of A2AR called spare receptors. The purpose of this review is to present emerging experimental evidence supporting the existence of this adaptive adenosinergic response to ischaemia or inflammation in CAD. We believe that we have achieved a breakthrough in the understanding and modelling of spare A2AR, based upon a new concept allowing for a new and non-invasive CAD management.

Prognostic Value of Exercise Stress Test and Dobutamine Stress Echo in Patients with Known Coronary Artery Disease

2009 ◽  
Vol 26 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Francesca Innocenti ◽  
Francesca Caldi ◽  
Irene Tassinari ◽  
Chiara Agresti ◽  
Costanza Burgisser ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Prognostic Value ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Dobutamine Stress ◽  
Exercise Stress ◽  
Stress Echo ◽  
Artery Disease

Using Incremental High-Sensitive Cardiac Troponin T to Increase the Diagnostic Accuracy of Exercise Stress Test

2021 ◽  
Vol 104 (2) ◽  
pp. 169-175
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Cardiac Troponin T ◽  
Delta Change ◽  
Artery Disease

Background: Exercise stress test (EST) is the most practical method to diagnose coronary artery disease (CAD). Although it has a high negative predictive value (NPV), the positive predictive value (PPV) is low. Objective: To increase the diagnostic accuracy of EST by combining the results with the delta change of high-sensitive cardiac troponin T (hscTnT) levels during stress exercise. Materials and Methods: The authors conducted a diagnostic study in patients presenting with chest pain and having intermediate pretest probability of CAD who underwent EST at Queen Sirikit Heart Center of the Northeast in Khon Kaen, Thailand, between July 2018 and January 2019. Two blood samples were collected to measure hs-cTnT at 5-minute before and at 1-hour after exercise. The diagnosis of CAD was made from the coronary angiography (CAG) or coronary computed tomography angiography (CCTA) result. The authors created a ROC curve from the hs-cTnT delta change, selected a value that had high sensitivity, and combined it with EST results to enhance the PPV predicting CAD. Results: Eighty-one patients were included in the present study. Thirty-one (38.3%) had positive EST, 47 (58.0%) had negative EST, and three (3.7%) had inconclusive results. To confirm the diagnosis of significant CAD, CAG was performed in 33 (40.7%) patients, and CCTA was performed in seven (8.6%) patients. Forty-two (51.8%) patients were determined not to have significant CAD based solely on negative EST results. Sixteen (19.8%) patients were in the CAD group and 65 (80.2%) in the non-CAD group. The average hs-cTnT at baseline, at 1-hour after EST, and delta change of patients in the CAD group were greater than those in the non-CAD group (7.81±3.62 ng/L and 4.83±2.97 ng/L, p<0.001, 9.21±4.41 ng/L and 4.94±2.92 ng/L, p<0.001, 17.99% and 9.18%, p=0.09, respectively). When the authors used a hs-cTnT delta-change of 3% as a cutoff point and combined this with the EST results, the PPV increased from 48% when using the EST alone to 63.2%. Conclusion: Combining hs-cTnT delta change during an EST with EST results could raise the PPV of CAD diagnosis in patients with chest pain who had intermediate CAD pretest probability. Keywords: Exercise stress test, Coronary artery disease, High-sensitive cardiac troponin T

scholarly journals Athens QRS Score as a Predictor of Coronary Artery Disease in Patients With Chest Pain and Normal Exercise Stress Test

2016 ◽  
Vol 5 (6) ◽  
Author(s):  
Raza Alvi ◽  
Eduard Sklyar ◽  
Robert Gorski ◽  
Moustapha Atoui ◽  
Maryam Afshar ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Artery Disease
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