Document Detail

Comparison of S-T segment/heart rate slope with exercise thallium imaging and conventional S-T segment criteria in detecting coronary artery disease: effect of exercise level on accuracy.
MedLine Citation:
PMID:  9570439     Owner:  NLM     Status:  MEDLINE    
The S-T segment/heart rate (ST/HR) slope has been proposed as a more accurate electrocardiographic criterion for the diagnosis of coronary artery disease, but studies comparing the diagnostic value of the ST/HR slope with exercise thallium imaging are scant. The aims of this study were to assess the diagnostic accuracy of the ST/HR slope, conventional S-T segment criteria and exercise thallium imaging in detecting coronary artery disease and to evaluate the effect of exercise level on the sensitivity and specificity of these three techniques. Ninety consecutive patients underwent treadmill testing and exercise thallium single-photon emission computed tomography (SPECT) simultaneously. All 90 patients also underwent coronary angiography within 1 month of the exercise test. We found that exercise thallium SPECT had a significantly higher diagnostic accuracy than either the ST/HT slope or conventional S-T segment criteria (thallium imaging 82%, ST/HR slope 67%, conventional S-T segment criteria 63%). The overall accuracy of the ST/HR slope was slightly but insignificantly greater than conventional S-T segment criteria (ST/HR slope 67%, conventional S-T segment criteria 63%; p = 0.639). In 50 patients with a lower exercise level, defined as not achieving 85% of their maximal predicted heart rate, the accuracy of the ST/HR slope was insignificantly greater (ST/HR slope 72%, conventional S-T segment criteria 66%; p = 0.517). In 40 patients with adequate exercise, the accuracy rate was the same (60%) for both the ST/HR slope and conventional S-T segment criteria. We conclude that exercise thallium imaging is more accurate than the ST/HR slope in diagnosing coronary artery disease and that the accuracy of the ST/HR slope is marginally better than conventional S-T segment criteria only in patients with a lower exercise level, and not in those with adequate exercise.
Y B Liu; P J Huang; C T Su; P U Chieng; C C Wu; Y L Ho
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Cardiology     Volume:  89     ISSN:  0008-6312     ISO Abbreviation:  Cardiology     Publication Date:  1998 Mar 
Date Detail:
Created Date:  1998-06-22     Completed Date:  1998-06-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1266406     Medline TA:  Cardiology     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  229-34     Citation Subset:  IM    
Department of Internal Medicine, National Taiwan University Hospital, Taipei, ROC.
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MeSH Terms
Coronary Disease / diagnosis*,  physiopathology
Diagnosis, Differential
Exercise Test / methods
Heart Catheterization
Heart Rate / physiology*
Middle Aged
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
Thallium Radioisotopes / diagnostic use*
Tomography, Emission-Computed, Single-Photon*
Reg. No./Substance:
0/Thallium Radioisotopes

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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