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Comparison of Cold Pressor and Exercise Radionuclide Angiocardiography in Coronary Artery Disease

Baylor College of Medicine, and the Veterans Administration Medical Center, Houston, Texas

Correspondence: For reprints contact: Mario S. Verani, MD, Section of Cardiology, Baylor College of Medicine and The Methodist Hospital, 6535 Fanin-MS F905, Houston, Texas 77030.

ABSTRACT

To investigate the role of the cold pressor test (CPT) with radionuclide angiocardiography in the diagnosis of coronary artery disease (CAD), we performed angiocadriography in 52 patients (18 with angiographically normal coronary arteries and 34 with CAD) during the resting state, CPT, and supine bicycle exercise (EX). In normal subjects, left ventricular ejection fraction (EF) was unchanged between rest (58 ± 9%) and CPT (59 ± 9%, p = ns), but increased during maximal EX (69 ± 9%, p < 0.01). In CAD patients, EF fell from 55 ± 9% at rest to 49 ± 9% during CPT (p < 0.01), and to 53 ± 11% during EX (p = ns vs. rest). Twenty-seven CAD patients (79%) developed new or worsening areas of dyssynergy during CPT, vs. 25 patients (73%) during EX. Thus, the cold pressor test with radiocardiography appears to be a useful noninvasive test for the diagnosis and functional evaluation of CAD, particularly in patients unable to perform a satisfactory exercise test.

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