Ejection fraction and regional wall motion at rest and during stress in the diagnosis of coronary artery disease.

Stress radio nuclide ventriculography is used to determine ejection fraction and changes in regional wall motion for the detection of ischemia-induced left ventricular dysfunction in patients with coronary artery disease. We have evaluated the relative sensitivity of regional wall motion and of ejection fraction during hand-grip and cold pressor test, in 21 patients with angina pectoris and documented coronary artery disease at angiography. Regional wall motion appeared a more sensitive index than global ejection fraction producing only two false negative cases. Ejection fraction showed great variability among the patients during both hand-grip and cold pressor test. This might be explained by the fact that both tests do not produce a sufficient degree of ischemic stress on the left ventricle. Hand-grip and cold pressor tests appear useful alternative to dynamic exercise in the diagnosis of coronary artery disease being also safe and simple to perform.