Source of Support: None, Conflict of Interest: None
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Detection of kinematically subtle coronary artery disease (CAD) is quite difficult when there is normal global left ventricular ejection fraction response to supine ergometric (isotonic) exercise. A new index of 'left ventricular synergic pumping efficiency' (LV-SPE) has been defined conceptually and mathematically. Hand-grip (isometric) stress induced change of LV-SPE has been found to be a very useful parameter in detecting CAD in the presence of minimally produced wall motion abnormalities, which are liable to be otherwise scintigraphically too blurred when evaluated by isotonic exercise methods and thus evade proper analysis.
