Document Detail

ST segment elevation in lead aVR during exercise testing is associated with LAD stenosis.
MedLine Citation:
PMID:  17019610     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To evaluate, in patients with chest pain, the diagnostic value of ST elevation (STE) in lead aVR during stress testing prior to (99m) Tc-sestamibi scanning correlating ischaemic territory with angiographic findings. METHODS: Consecutive patients attending for (99m) Tc-sestamibi myocardial perfusion imaging (MPI) completed a treadmill protocol. Peak exercise ECGs were coded. STE >or=0.05 mV in lead aVR was considered significant. Gated perfusion images and findings at angiography were assessed. RESULTS: STE in lead aVR occurred in 25% (138/557) of the patients. More patients with STE in aVR had a reversible defect on imaging compared with those who had no STE in aVR (41%, 56/138 vs 27%, 114/419, p=0.003). Defects indicating a left anterior descending artery (LAD) culprit lesion were more common in the STE in aVR group (20%, 27/138 vs 9%, 39/419, p=0.001). There was a trend towards coronary artery stenosis (>70%) in a double vessel distribution involving the LAD in those patients who had STE in aVR compared with those who did not (22%, 8/37 vs 5%, 4/77, p=0.06). Logistic regression analysis demonstrated that STE in aVR (OR 1.36, p=0.233) is not an independent predictor of inducible abnormality when adjusted for STD >0.1 mV (OR 1.69, p=0.026). However, using anterior wall defect as an end-point, STE in aVR (OR 2.77, p=0.008) was a predictor even after adjustment for STD (OR 1.43, p=0.281). CONCLUSION: STE in lead aVR during exercise does not diagnose more inducible abnormalities than STD alone. However, unlike STD, which is not predictive of a territory of ischaemia, STE in aVR may indicate an anterior wall defect.
Johanne Neill; Heather J Shannon; Amanda Morton; Alison R Muir; Mark Harbinson; Jennifer A Adgey
Publication Detail:
Type:  Journal Article     Date:  2006-09-22
Journal Detail:
Title:  European journal of nuclear medicine and molecular imaging     Volume:  34     ISSN:  1619-7070     ISO Abbreviation:  Eur. J. Nucl. Med. Mol. Imaging     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-04-03     Completed Date:  2007-08-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101140988     Medline TA:  Eur J Nucl Med Mol Imaging     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  338-45     Citation Subset:  IM    
Regional Medical Cardiology Centre, Royal Victoria Hospital, Grosvenor Road, Belfast, UK.
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MeSH Terms
Arrhythmias, Cardiac / diagnosis*,  epidemiology*
Coronary Stenosis / diagnosis*,  epidemiology*
Electrocardiography / statistics & numerical data*
Exercise Test / statistics & numerical data*
Great Britain / epidemiology
Middle Aged
Risk Assessment / methods*
Risk Factors
Statistics as Topic

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

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