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      Ischemic and Nonischemic Patterns of Diastolic Abnormalities during Isometric Handgrip Exercise

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          Abstract

          This study establishes the clinical value of the recently introduced handgrip-apexcardiographic test (HAT) as an additional tool for distinguishing exercise-induced diastolic abnormalities in coronary artery disease (CAD) patients from those in patients with hypertrophic cardiomyopathy (HCM). This stress test reliably assessing differences in diastolic indices during handgrip between 305 healthy volunteers and 39 patients with CAD without prior infarction as well as 17 patients with HCM showed two different patterns of handgrip-induced pathological changes in these indices. An ‘ischemic diastolic response’ was empirically defined by the presence of either a handgrip-induced more than doubling of a resting normal relative A wave to total height of the apexcardiogram (ischemic compliance response) or a pathological prolongation of a resting normal total apexcardiographic relaxation time (ischemic relaxation response); whereas a ‘nonischemic diastolic response’ was defined by the presence of a positive HAT and by absence of the above-mentioned ischemic criteria. An ischemic pattern of diastolic abnormalities was present in 72% of CAD patients, whereas 94% of HCM patients showed a ‘nonischemic’ diastolic response. These results confirm that in CAD patients there is a typical response of diastolic apexcardiographic indices to isometric stress and, therefore, this simple stress test could be potentially useful in separating these patients from those with nonischemic myocardial disease states.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1995
          1995
          19 November 2008
          : 86
          : 3
          : 179-188
          Affiliations
          Diagnostic and Therapeutic Center of Athens ‘Hygeia’, Athens, Greece
          Article
          176871 Cardiology 1995;86:179–188
          10.1159/000176871
          7614488
          © 1995 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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          Pages: 10
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