Document Detail


Normalization of abnormal T-waves during stress testing does not identify patients with reversible perfusion defects.
MedLine Citation:
PMID:  17680621     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine if T-wave normalization during exercise or dobutamine stress testing identified patients with myocardial ischemia as indicated by reversible perfusion defects. METHODS: Exercise or dobutamine stress tests with perfusion scintigraphy were performed in 1,173 patients with abnormal T-waves on their baseline electrocardiograms. The results of perfusion scintigraphy were compared in patients with and without stress-induced T-wave normalization. RESULTS: Only 33 of 270 patients with reversible perfusion defects (12.2%) had T-wave normalization during stress while 76.4% of 140 patients who had T-wave normalization during stress did not have a reversible perfusion defect. Results were similar for patients who did or did not reach 85% of their maximal predicted heart rate, for patients with and without Q-wave infarction on the baseline EKG and for patients who did or did not have ischemic ST-segment depression during stress. CONCLUSIONS: T-wave normalization during stress testing has low sensitivity and poor positive predictive value for stress-induced reversible myocardial ischemia.
Authors:
Henry S Loeb; Nicholas C Friedman
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  30     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-13     Completed Date:  2008-03-21     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  403-7     Citation Subset:  IM    
Copyright Information:
(c) 2007 Wiley Periodicals, Inc.
Affiliation:
Department of Cardiology, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois 60141, USA. HSL4134@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Atropine / diagnostic use
Blood Pressure / drug effects
Cardiotonic Agents / diagnostic use
Case-Control Studies
Dobutamine / diagnostic use
Electrocardiography*
Exercise Test*
Female
Heart Conduction System / drug effects,  physiopathology*
Heart Rate / drug effects
Humans
Male
Middle Aged
Myocardial Ischemia / diagnosis*,  etiology,  physiopathology*
Myocardial Reperfusion*
Organophosphorus Compounds / diagnostic use
Organotechnetium Compounds / diagnostic use
Radiopharmaceuticals / diagnostic use
Regression Analysis
Research Design
Retrospective Studies
Sensitivity and Specificity
Stress, Physiological / complications
Technetium Tc 99m Sestamibi / diagnostic use
Tomography, Emission-Computed, Single-Photon
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Organophosphorus Compounds; 0/Organotechnetium Compounds; 0/Radiopharmaceuticals; 0/technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane; 109581-73-9/Technetium Tc 99m Sestamibi; 34368-04-2/Dobutamine; 51-55-8/Atropine

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


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