JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
QUICK SEARCH:   [advanced]


     

J Am Coll Cardiol, 1983; 2:21-29
© 1983 by the American College of Cardiology Foundation
This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Colby, J
Right arrow Articles by Mattleman, S
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Colby, J
Right arrow Articles by Mattleman, S

Hemodynamic, angiographic and scintigraphic correlates of positive exercise electrocardiograms: emphasis on strongly positive exercise electrocardiograms

J Colby, AH Hakki, AS Iskandrian, and S Mattleman

The results of treadmill exercise electrocardiograms were analyzed in 179 patients with coronary artery disease (greater than or equal to 50% diameter narrowing of one or more vessels). Exercise thallium-201 images were available in 141 of these patients. The exercise electrocardiograms were strongly positive in 51 patients, mildly positive (1 to 1.9 mm ST depression) in 28 patients, falsely negative in 23 patients and uninterpretable in 77 patients. The degree of exercise-induced ST depression did not correlate with left ventricular function, extent of coronary artery disease, exercise heart rates and rate-pressure product and extent of exercise-induced thallium-201 perfusion abnormality. However, the presence of a strongly positive exercise electrocardiogram only at heart rates of 140 beats/min or more or stage III or higher of the Bruce protocol was predictive of less extensive coronary disease and perfusion abnormalities. Thus, the magnitude of ST depression as such during exercise is not predictive of the extent of coronary disease, even in patients with 3 mm or greater ST depression. However, a strongly positive exercise electrocardiogram in the first two stages of the Bruce protocol or at a heart rate of less than 140 beats/min was related to the extent of coronary artery disease and impaired myocardial perfusion, and identified patients with more extensive coronary artery disease and jeopardized myocardium. Therefore, caution should be used in interpreting prognostic data on the basis of the degree of exercise-induced ST depression alone.


This article has been cited by other articles:


Home page
 HeartHome page
T Kawasaki, A Azuma, T Kuribayashi, T Taniguchi, S Asada, T Kamitani, S Kawasaki, H Matsubara, and H Sugihara
Enhanced vagal modulation and exercise induced ischaemia of the inferoposterior myocardium
Heart, March 1, 2006; 92(3): 325 - 330.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. E. Tavel
Stress Testing in Cardiac Evaluation : Current Concepts With Emphasis on the ECG
Chest, March 1, 2001; 119(3): 907 - 925.
[Full Text] [PDF]

Home page
 NEJMHome page
A. P. Michaelides, Z. D. Psomadaki, P. E. Dilaveris, D. J. Richter, G. K. Andrikopoulos, K. D. Aggeli, C. I. Stefanadis, and P. K. Toutouzas
Improved Detection of Coronary Artery Disease by Exercise Electrocardiography with the Use of Right Precordial Leads
N. Engl. J. Med., February 4, 1999; 340(5): 340 - 345.
[Abstract] [Full Text] [PDF]


HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
Copyright © 1983 by the American College of Cardiology Foundation.