Document Detail

New parameters in the interpretation of exercise testing in women: QTc dispersion and QT dispersion ratio difference.
MedLine Citation:
PMID:  12000077     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: It has been reported that the increase of QT dispersion (QTD) that occurs due to increased inhomogeneity of the ventricular repolarization because of transient ischemia obtained by standard 12-lead electrocardiogram (ECG), the changes during exercise, and the differences between exercise and rest increase the accuracy of exercise test in the diagnosis of coronary artery disease (CAD). HYPOTHESIS: This study was designed to investigate the value of QTD parameters, which are reported to increase the diagnostic accuracy of exercise test in women. METHODS: Ninety-seven women who had undergone coronary angiography and exercise test were evaluated for diagnosis of chest pain. QT dispersion was calculated using the measurements of the highest and lowest values of QT interval obtained by ECG during peak exercise. The QTc using Bazett's equation, and the QTD ratio (QTDR) using QT/RR were calculated, and QTcD and QTD ratios were obtained. The difference between QTcD and QTDR was determined by extracting the rest values from the exercise values. RESULTS: The groups with normal coronaries (n = 48), single-vessel CAD (n = 24), and multivessel CAD (n = 25) were compared. The obtained QTD parameters at peak exercise and their differences between exercise and rest were found to be significantly increased in patients with CAD (p <0.001). Furthermore, these parameters were found to be higher in the patients with multivessel CAD than in those with single-vessel disease (p < 0.05). With the parameters QTcD > 60 ms and QTDR > 10%, greater sensitivity and specificity were obtained compared with ST-segment depression. The highest diagnostic accuracy was obtained with the QTD parameters calculated from the differences between rest and exercise values. The diagnostic accuracy of the difference of QTcD > 15 ms and the difference of QTDR > 5% was relatively higher than the other parameters (sensitivity, specificity, and negative and positive predictor values are 84, 88, 84, 87% and 84, 96, 85, 95%, respectively). CONCLUSION: The use of QTD parameters as variables of ECG, which is easily obtainable in the evaluation of exercise ECG in women, increases the diagnostic accuracy of the exercise test. In addition, the evaluation of QTD variables may provide information about the incidence of CAD.
Kurtuluş Ozdemir; Bülent B Altunkeser; Mustafa Aydin; Ali Ozeren; Gülizar Daniş; Hasan Gök
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  25     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-05-09     Completed Date:  2002-10-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  187-92     Citation Subset:  IM    
Department of Cardiology, Faculty of Medicine, Selçuk University, Konya, Turkey.
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MeSH Terms
Analysis of Variance
Coronary Artery Disease / diagnosis*
Exercise Test*
Middle Aged
Predictive Value of Tests
Regression Analysis
Sensitivity and Specificity

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