Scintigraphic left ventricular function during exercise in elderly patients with coronary artery disease.

Left ventricular performance at rest and during supine symptom-limited exercise was determined by radionuclide ventriculography (RNV) in 65 subjects of the age of 65 years or older. Eleven subjects had no evidence of coronary artery disease (CAD) by history or submaximal stress ECG. In this control group left ventricular ejection fraction (LV-EF) increased from 0.62 +/- 0.09 (mean +/- SD) to 0.69 +/- 0.08 with a further increase in regional wall motion. There were 10 patients with a history of hypertension or atypical angina without infarction. Left ventricular ejection fraction (LVEF) at rest was 0.65 +/- 0.11 and showed no significant increase during exercise (mean exercise tolerance: 73 +/- 33W). Nineteen patients had an anterior infarction. LVEF at rest was 0.44 +/- 0.16 and as a group showed no change during exercise (mean exercise tolerance: 70 +/- 23W). Only two of 19 patients showed an increase of LVEF greater than 0.10. There were 19 patients with inferior infarction. LVEF at rest was 0.49 +/- 0.08 and showed also no significant change during exercise (mean exercise tolerance: 80 +/- 25W). Four of 19 patients showed an increase of LVEF in response to exercise. The five patients with two or more infarctions showed a markedly decreased resting LVEF of 0.28 +/- 0.11 with a further decline (0.22 +/- 0.09) during exercise (mean exercise tolerance: 45 +/- 32W). Therefore, age by itself does not significantly impair left ventricular ejection fraction at rest and during exercise. RNV appears as a valuable method in evaluating left ventricular performance of older patients with a similar response to exercise as in younger persons without or with comparable disease.