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Exaggerated carotid sinus massage responses are related to severe coronary artery disease in patients being evaluated for chest pain. | LitMetric

AI Article Synopsis

  • Previous research indicates that responses to carotid sinus massage are linked to factors like age and types of artery disease.
  • This study aimed to explore carotid sinus hypersensitivity as a potential indicator for coronary artery disease, especially left main stem disease, in patients with chest pain.
  • The findings showed that 26.6% of patients exhibited carotid sinus hypersensitivity, which was significantly associated with left main stem disease and provided useful diagnostic sensitivity, specificity, and predictive value.

Article Abstract

Background: Previous studies have reported that carotid sinus massage responses are associated with advancing age and carotid or coronary artery disease.

Hypothesis: This study was undertaken to investigate the potential role of carotid sinus hypersensitivity as a marker for the presence of coronary artery disease, and especially left main stem disease, in patients who were referred for evaluation of chest pain.

Methods: Toward this end, carotid sinus stimulation with simultaneous recordings of the electrocardiogram and aortic pressure was performed before coronary arteriography in 150 selected consecutive patients (mean age 59.4+/-9 years) who were referred for evaluation of chest pain.

Results: Coronary artery disease was present in 118 patients (78.7%); of these, 35 had single-vessel disease, 35 had double-vessel disease, 33 had triple-vessel disease, and 15 had left main stem with or without such vessel disease. Carotid sinus hypersensitivity was found in 40 patients (26.6%). The incidence of hypersensitivity in patients with single-, double-, or triple-vessel disease and left main stem disease was 8.5, 14.2, 57.5, and 73.3%, respectively. Stepwise multiple logistic regression analysis revealed that left main stem disease was significantly and independently related to the presence of carotid sinus hypersensitivity (p < 0.05). In addition, the presence of hypersensitivity had 73.3% sensitivity, 86.2% specificity, and 96.3% negative predictive value for the presence of left main stem disease.

Conclusion: In patients being evaluated for suspected ischemic heart disease, carotid sinus massage responses are related to severe coronary disease. The absence of hypersensitivity may reflect absence of left main stem disease.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6653916PMC
http://dx.doi.org/10.1002/clc.4960250406DOI Listing

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