Document Detail

Inability of exercise-induced R wave changes to predict coronary artery disease.
MedLine Citation:
PMID:  7064817     Owner:  NLM     Status:  MEDLINE    
To determine the value of exercise-induced R wave changes in diagnosing coronary disease 200 patients undergoing coronary angiography were studied with 16 lead precordial exercise mapping. R wave amplitude was calculated before and immediately after exercise as the sum of R in all 16 leads, the sum of the R waves in the left plus the S waves in the right precordial leads, as well as the sum of the R waves only in those leads that manifested S-T depression. Coronary artery disease was found in 154 patients, S-T depression developed in 122 (sensitivity 79 percent); the sum of R increased or remained unchanged in 61 and decreased in 93 (sensitivity 40 percent). Forty-six patients did not have coronary artery disease; S-T depression developed in 5 (specificity 89 percent); the sum of R increased or was unchanged in 30 and decreased in 16 (specificity 35 percent). Similar results were obtained using the other criteria for calculating R wave amplitude. Exercise-induced S-T depression was identified in 5. 1 +/- 2.6 (mean +/- standard deviation) of the 16 precordial leads and in 2.0 +/- 1. 1 of the chest leads of the standard electrocardiogram (p less than 0.01). Thus, electrocardiographic alterations found in the standard chest leads represent only a small variable proportion of the total projection. When the whole precordial area was analyzed, R wave changes were so unpredictable that they could not be used in the diagnosis of coronary disease.
K Fox; D England; A Jonathan; A Selwyn
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  49     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1982 Mar 
Date Detail:
Created Date:  1982-05-21     Completed Date:  1982-05-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  674-9     Citation Subset:  AIM; IM    
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MeSH Terms
Coronary Angiography
Coronary Disease / diagnosis*
Diagnosis, Differential
Exercise Test*
Heart Ventricles / radiography
Middle Aged

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

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