Document Detail

Exercise testing in women with chest pain: applications and limitations of computer analysis.
MedLine Citation:
PMID:  8287212     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The frequent occurrence of false-positive results of standard electrocardiographic (ECG) treadmill exercise testing in women limits its diagnostic value. In men, a commercially available computer-derived treadmill exercise score (TES), which quantifies the exercise ECG, has been reported to have high diagnostic accuracy. The purpose of this study was to test TES accuracy in women. METHODS: We prospectively evaluated 87 middle-aged women with chest pain and no previous history of cardiac events who underwent exercise testing and coronary arteriography (Group 1). Also, in 15 young symptomatic women with mitral valve prolapse and 15 age- and sex-matched controls (Group 2) we compared the TES score with standard exercise testing. In 25 Group 1 patients, TES could not be evaluated because of technical reasons. RESULTS: By standard ECG criteria, 18 out of the 28 women in Group 1 with coronary artery disease (55%) had a false-positive test, whereas the TES score reduced the false positives to 5 (15%, P < 0.001). In Group 2, the false-positive rate was improved from 12 (40%) to zero with TES (P < 0.001). Overall specificity was thus improved from 52% to 92% by TES (P < 0.0001). There was a trend towards improving the positive predictive value (52% versus 74%) and diagnostic accuracy (57% versus 69%) (P = 0.1), but sensitivity and negative predictive value were not improved with TES. CONCLUSIONS: The treadmill exercise score improves the specificity of exercise ECG especially in women with mitral valve prolapse and atypical chest pain, but its overall utility and accuracy in women is lower than that reported in men.
A D Walling; M H Crawford
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Coronary artery disease     Volume:  4     ISSN:  0954-6928     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  1993 Sep 
Date Detail:
Created Date:  1994-02-22     Completed Date:  1994-02-22     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  783-9     Citation Subset:  IM    
Division of Cardiology, University of Texas Health Science Center at San Antonio.
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MeSH Terms
Angina Pectoris / diagnosis*,  physiopathology
Coronary Disease / diagnosis,  physiopathology
Diagnosis, Computer-Assisted*
Exercise Test*
False Negative Reactions
False Positive Reactions
Heart Rate
Middle Aged
Mitral Valve Prolapse / diagnosis*,  physiopathology
Predictive Value of Tests
Prospective Studies
Sensitivity and Specificity
Grant Support

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

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