Document Detail


Exercise electrocardiography detection of coronary artery disease by ST-segment depression/heart rate hysteresis in women: the Finnish Cardiovascular Study.
MedLine Citation:
PMID:  19068271     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The performance of exercise electrocardiography (ECG) for the detection of coronary artery disease (CAD) in women has been limited. The recently developed computerized variable, ST-segment depression/heart rate (ST/HR) hysteresis, has been proved to detect CAD in men more accurately than traditional methods. However, the diagnostic performance of ST/HR hysteresis has not been evaluated in women. MATERIALS AND METHODS: The study population comprised 161 female patients from the Finnish Cardiovascular Study (FINCAVAS). All patients were referred for a routine bicycle exercise test. The maximum values of ST/HR hysteresis, ST/HR index, ST-segment depression at peak exercise (STpeak), at the end of one (ST1rec) and three (ST3rec) minutes of post-exercise were determined. Significant CAD was present in 48, while 65 women showed no angiographic CAD. Also a group of 48 women with low likelihood of CAD (LLC) was formed. Diagnostic performance of variables was assessed by receiver operating characteristic (ROC) analysis. Furthermore, sensitivity values at 80% specificity and specificities at 80% sensitivity were determined. RESULTS: In a comparison between CAD and LLC groups, the ROC areas for ST/HR hysteresis, ST/HR index, STpeak, ST1rec and ST3rec were 0.89, 0.74, 0.65, 0.84 and 0.73, and sensitivities at 80% specificity were 88%, 67%, 52%, 75% and 60%, respectively. Comparing CAD and no-CAD groups, the ROC areas were 0.73, 0.67, 0.56, 0.63 and 0.60, and specificities at 80% sensitivity were 60%, 38%, 27%, 33% and 30%. CONCLUSIONS: ST/HR hysteresis is a more competent method in CAD detection in women than ST-segment depression or ST/HR index.
Authors:
Kati Svart; Rami Lehtinen; Tuomo Nieminen; Kjell Nikus; Terho Lehtimäki; Tiit Kööbi; Kari Niemelä; Mari Niemi; Väinö Turjanmaa; Mika Kähönen; Jari Viik
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2008-12-07
Journal Detail:
Title:  International journal of cardiology     Volume:  140     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-12     Completed Date:  2010-07-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  182-8     Citation Subset:  IM    
Copyright Information:
Copyright 2008 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Biomedical Engineering, Tampere University of Technology, Finland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cohort Studies
Coronary Artery Disease / diagnosis*,  epidemiology
Diagnosis, Computer-Assisted / methods,  standards
Electrocardiography / methods*,  standards*
Exercise Test / methods*,  standards*
Female
Finland / epidemiology
Humans
Middle Aged
Prognosis
ROC Curve
Reproducibility of Results
Risk Factors
Sensitivity and Specificity
Women's Health

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


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