Document Detail

Right-sided chest leads in exercise testing for detection of coronary restenosis.
MedLine Citation:
PMID:  20162735     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The incorporation of right-sided chest leads (V(3)R through V(5)R) into standard exercise testing has been reported to improve its diagnostic utility. HYPOTHESIS: The purpose of this study was to evaluate any improvement in the ability of exercise testing in detecting restenosis, using additional V(3)R through V(5)R leads, in asymptomatic patients undergoing percutaneous coronary intervention (PCI) in the right coronary artery (RCA) or/and left circumflex (LCX). METHODS: We studied 172 consecutive patients (54 +/- 7 years old, 106 males) undergoing PCI in RCA or/and LCX. A treadmill test had been performed before PCI. Six months later, all patients underwent a second treadmill test and arteriography in order to detect silent ischemia due to restenosis. Recordings during exercise were obtained with the standard 12-leads plus V(3)R through V(5)R. RESULTS: Out of 172 patients, 106 had stenosis in RCA, 35 in LCX, and 31 in both vessels while 6 months later, restenosis was detected in 8 (for RCA), 3 (for LCX), and 3 (for both vessels) patients respectively. Sensitivity, specificity, positive prognostic value, negative prognostic value, and accuracy of exercise testing performed post PCI were ameliorated using V(3)R through V(5)R (79% vs 57%, 97% vs 80%, 69% vs 21%, 98% vs 95%, and 95% vs 78% respectively, P < .05 for all except negative prognostic value). Maximal exercise-induced ST-segment deviation (in mm) was not changed post PCI in 12 leads (1.4 +/- 0.2 vs 1.5 +/- 0.2, P = NS) while it was decreased in V(3)R through V(5)R (0.2 +/- 0.2 vs 1.2 +/- 0.3, P < .01). CONCLUSIONS: The addition of V(3)R through V(5)R improves the diagnostic ability of standard exercise testing in detecting silent ischemia due to restenosis in patients undergoing PCI in RCA or/and LCX.
Andreas P Michaelides; Charalampos I Liakos; Charalambos Antoniades; Polychronis E Dilaveris; Eleftherios G Tsiamis; Konstantinos P Tsioufis; Konstantina D Aggeli; Konstantinos P Toutouzas; Leonidas G Raftopoulos; Christodoulos I Stefanadis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  33     ISSN:  1932-8737     ISO Abbreviation:  Clin Cardiol     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-15     Completed Date:  2010-05-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  236-40     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Wiley Periodicals, Inc.
Exercise Laboratory, 1st University Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary
Chi-Square Distribution
Coronary Angiography
Coronary Circulation
Coronary Restenosis / diagnosis*,  physiopathology,  therapy
Exercise Test / instrumentation*
Middle Aged
Predictive Value of Tests
Sensitivity and Specificity
Statistics, Nonparametric

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

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