open access

Vol 14, No 6 (2007)
Original articles
Published online: 2007-10-10
Submitted: 2013-01-14
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Exercise stress test and comparison of ST change with cardiac nucleotide catabolite production in patients with coronary artery disease

Sławomir Burakowski, Ryszard T. Smoleński, Jerzy Bellwon, Andrzej Kubasik, Dariusz Ciećwierz, Andrzej Rynkiewicz
Cardiol J 2007;14(6):573-579.

open access

Vol 14, No 6 (2007)
Original articles
Published online: 2007-10-10
Submitted: 2013-01-14

Abstract

Background: Uridine (Ur) and hypoxanthine (Hx) are the major end products of ischemic nucleotide breakdown in the human heart. Hypoxanthine is further metabolized to uric acid (UA). The aim of the study was the evaluation of whether changes in nucleotide concentrations during exercise correlate with electrocardiography (ECG) changes, and the severity of coronary artery disease (CAD).
Methods: Twenty-nine males with CAD and 11 controls without CAD (mean age 56.1 vs. 51.45) were subjected to treadmill exercise. The test was considered positive if ECG showed more then 1 mm ST segment depression. Venous blood samples taken before and 10 minut after the exercise were analysed by high performance liquid chromatography.
Results: Twenty-two out of 29 patients with CAD and 6 of 11 in the control group had abnormal exercise stress tests according to ECG criteria only. Mean ∆Ur was positive in the CAD group and negative in the control group (0.45 SEM ± 0.09 µM/L vs. -0.43 SEM ± 0.21 µM/L, p < 0.0001). ∆UA was positive in the CAD group (15.31 SEM ± 5.52 µM/L) and negative in the control group (15.31 SEM ± 5.52 µM/L vs. -48.18 SEM ± 13,8 µM/L, p < 0.00001); Hx increased in both groups, and the change was not significantly different. Correlations of CAD-index with ST depression, ∆Ur and ∆UA, were: r = 0.43 (p < 0.005), r = 0.62 (p < 0.001), and r = 0.39 (p < 0.01), respectively. Sensitivity of any increase of uridine was superior to 1.5 mm ST depression during exercise. Conclusions: Blood Ur and UA concentration changes during exercise correlate with severity of CAD. We observed slightly greater accuracy of uridine change in comparison to ST changes, thus being a possible new tool in diagnosis of CAD. (Cardiol J 2007; 14: 573-579).

Abstract

Background: Uridine (Ur) and hypoxanthine (Hx) are the major end products of ischemic nucleotide breakdown in the human heart. Hypoxanthine is further metabolized to uric acid (UA). The aim of the study was the evaluation of whether changes in nucleotide concentrations during exercise correlate with electrocardiography (ECG) changes, and the severity of coronary artery disease (CAD).
Methods: Twenty-nine males with CAD and 11 controls without CAD (mean age 56.1 vs. 51.45) were subjected to treadmill exercise. The test was considered positive if ECG showed more then 1 mm ST segment depression. Venous blood samples taken before and 10 minut after the exercise were analysed by high performance liquid chromatography.
Results: Twenty-two out of 29 patients with CAD and 6 of 11 in the control group had abnormal exercise stress tests according to ECG criteria only. Mean ∆Ur was positive in the CAD group and negative in the control group (0.45 SEM ± 0.09 µM/L vs. -0.43 SEM ± 0.21 µM/L, p < 0.0001). ∆UA was positive in the CAD group (15.31 SEM ± 5.52 µM/L) and negative in the control group (15.31 SEM ± 5.52 µM/L vs. -48.18 SEM ± 13,8 µM/L, p < 0.00001); Hx increased in both groups, and the change was not significantly different. Correlations of CAD-index with ST depression, ∆Ur and ∆UA, were: r = 0.43 (p < 0.005), r = 0.62 (p < 0.001), and r = 0.39 (p < 0.01), respectively. Sensitivity of any increase of uridine was superior to 1.5 mm ST depression during exercise. Conclusions: Blood Ur and UA concentration changes during exercise correlate with severity of CAD. We observed slightly greater accuracy of uridine change in comparison to ST changes, thus being a possible new tool in diagnosis of CAD. (Cardiol J 2007; 14: 573-579).
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Keywords

exercise stress test; coronary artery disease; uridine; hypoxanthine; uric acid; pyrimidine and purine catabolism in the human heart

About this article
Title

Exercise stress test and comparison of ST change with cardiac nucleotide catabolite production in patients with coronary artery disease

Journal

Cardiology Journal

Issue

Vol 14, No 6 (2007)

Pages

573-579

Published online

2007-10-10

Bibliographic record

Cardiol J 2007;14(6):573-579.

Keywords

exercise stress test
coronary artery disease
uridine
hypoxanthine
uric acid
pyrimidine and purine catabolism in the human heart

Authors

Sławomir Burakowski
Ryszard T. Smoleński
Jerzy Bellwon
Andrzej Kubasik
Dariusz Ciećwierz
Andrzej Rynkiewicz

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