Circulation, Vol 62, 697-703, Copyright © 1980 by American Heart Association
KA Brown, JD Maloney, CH Smith, GO Haritzler and DM Ilstrup
Heart rate and blood pressure responses during and after carotid sinus
massage were examined in 66 patients just before coronary angiography. A
significant relationship was found between heart rate and blood pressure
responses and (1) angina pectoris class, (2) total coronary artery disease
score and (3) presence of high-grade (> 90%) stenosis of any of the
three major coronary arteries. Only patients with contraction abnormalities
of the anterolateral left ventricular region had greater cardionhibitory
responses than patients with normal left ventricular angiograms. Among
patients with normal left ventricular angiograms, those with more than 50%
stenosis of one or more vessels had significantly (p < 0.01) greater
responses than those with no or minimal coronary artery disease. All 21
hypersensitive (asystole longer than 3 seconds) patients had significant
multivessel coronary artery stenoses or single-vessel high-grade stenosis
(greater than or equal to 90%) proximal to the atrioventricular nodal
artery. None of the 11 patients with normal coronary arteries had an
exaggerated response to carotid sinus massage. These data support the
association of an exaggerated response to carotid sinus massage in the
presence of symptomatic coronary artery disease and suggest that the
magnitude of response is influenced by the severity of the disease.
ARTICLES
Carotid sinus reflex in patients undergoing coronary angiography: relationship of degree and location of coronary artery disease to response to carotid sinus massage
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