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ST elevation in the lead aVR during exercise treadmill testing may indicate left main coronary artery disease.
MedLine Citation:
PMID:  20967704     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background: Exercise treadmill testing (ETT) is the most widely used method for evaluating patients with coronary artery disease. Predicting the left main coronary artery (LMCA) disease before invasive procedures is very important in risk assessment because of its severe clinical outcome. Aim: To examine whether ST elevation in lead aVR during ETT may suggest LMCA disease since the lead aVR is the reciprocal lead of LMCA. Methods: In this study, 61 patients with positive ETT were included. The study group consisted of 21 patients with ST elevation in lead aVR. Forty patients, also having positive ETT, but without ST elevation in lead aVR comprised the control group. All patients underwent coronary angiography. Results: Coronary angiography in the study group revealed significant LMCA stenosis in 16 (76%) patients, whereas LMCA disease was present in only 3 (8%) patients from the control group. There was no significant coronary artery stenosis in 5 patients in the study group and 12 patients in the control group. Of the 16 patients who had LMCA stenosis, 9 had isolated LMCA disease and 7 had additional stenotic lesions in LAD or circumflex coronary arteries. The sensitivity and specificity of ST segment elevation in lead aVR during ETT was 84% and 88%, respectively. The values of positive and negative predictive value of this finding in diagnosing the presence of LMCA were 76% and 93%, respectively. Conclusions: ST segment elevation in lead aVR during ETT may point to a high probability of the presence of LMCA disease. Kardiol Pol 2010; 68, 10: 1107-1111.
Authors:
Namik Ozmen; Omer Yiginer; Omer Uz; Ejder Kardesoglu; Mustafa Aparci; Zafer Isilak; Bekir Yilmaz Cingozbay; Bekir Sitki Cebeci; Halil Tolga Kocum
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kardiologia polska     Volume:  68     ISSN:  0022-9032     ISO Abbreviation:  Kardiol Pol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376352     Medline TA:  Kardiol Pol     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  1107-11     Citation Subset:  IM    
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