Handgrip-apexcardiographic test: a new mode of detecting patients with silent exercise-induced myocardial ischemia.

There are no simple noninvasive stress tests for detecting silent myocardial ischemia by assessing left ventricular (LV) diastolic abnormalities which are known to occur early on the onset of every ischemic episode. It has been proved that the LV apexcardiogram (ACG) reflects the LV pressure curve in early and late diastole and can be recorded during isometric handgrip (HG) exercise. To determine the clinical validity of HG-ACG-Test (HAT) in identifying patients with silent ischemia, 16 patients (8 with prior infarction) with angiographically documented coronary artery disease, positive treadmill electrocardiographic test and without symptoms were examined.