CHANGES IN LEFT-VENTRICULAR EJECTION FRACTION DURING TRANSIENT MYOCARDIAL-ISCHEMIA IN PATIENTS WITH ANGINA-PECTORIS AND SILENT ISCHEMIA

We compared the change in left ventricular ejection fraction during re st and exercise in 14 patients with angina pectoris and 14 patients wi th silent ischaemia. All patients had ischaemia defined as reversible defects at an exercise thallium myocardial scintigraphy. In the patien ts with angina pectoris the ejection fraction decreased from 44.0% (+/ -1 SD 13.4) at rest to 39.5% (+/-1 SD 11.2) during exercise (p=0.044). In the patients with silent ischaemia the ejection fraction decreased from 43.5% (+/-1 SD 14.0) to 39.8% (+/-1 SD 13.9) (p=0.045). The fall in left ventricular ejection fraction in the two groups was almost id entical (p=0.77). This study confirms with a sensitive detection of tr ansient ischaemia that silent ischaemia is accompanied with a fall in ejection fraction during exercise.