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Diagnostic value of the recovery time-course of ST slope on exercise ECG in discriminating false-from true-positive ST-Segment depressions
SAKURAGI S; TAKAKI H; TAGUCHI A
CIRC J , 2004, vol. 68, n° 10, p. 915-922 Doc n°: 115834 Localisation : Documentation IRR Descripteurs : FA2 - EXPLORATION EXAMENS BILANS - COEUR Using the exercise ECG for diagnosing coronary artery disease (CAD) is hampered by the occurrence of false-positive (FP) ST-segment depression. Because it is known that the recovery ST-T time-course in CAD differs from that in FP subjects, the ST slope may help discriminate FP from true-positive (TP) results. Methods and Results Treadmill digitized ECG from patients with significant ST-segment depressions and normal resting ECG were analyzed in 134 patients with CAD on angiography (>50% narrowing) and reversible perfusion defects (TP group), and 64 subjects with normal perfusion (FP group) on exercise single photon emission computed tomography. The ST slope between the J-point and J80 was measured every minute up to 6-min postexercise. The ST slope was significantly higher in FP than in TP at peak exercise, and at postexercise 1-, 2- and 3-min (p<0.01, all). Thereafter, it gradually increased in TP, while monotonically decreasing in FP. Its decrease from 3- to 6-min could correctly diagnose 88% of FP subjects, whereas it was found in only 19% of TP patients (total accuracy 83%). Conclusions The ST slope change from early to late recovery is a simple yet reliable marker for discriminating FP from TP ST-segment responses in subjects with a normal resting ECG. Langue : ANGLAIS Tiré à part : OUI |
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