Document Detail


Significance of signal-averaged P-wave changes during exercise in patients with coronary artery disease and correlation with angiographic findings.
MedLine Citation:
PMID:  1746463     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The maximal P-wave duration in all time-aligned leads, and the maximal P-wave amplitude in leads V5 and V6 were measured on a 12-lead, signal-averaged electrocardiogram during the recovery period of an exercise stress test (EST). The study group consisted of 75 patients with coronary artery disease (CAD) documented by greater than or equal to 50% diameter stenosis in 1 or more arteries and a control group of 47 subjects, 15 of them young volunteers and 32 with no or minimal coronary atherosclerosis and normal left ventricular function. All subjects underwent a symptom limited EST, with use of the Ellestad protocol. Signal-averaged P waves recorded before exercise, and for the first 6 minutes in recovery were measured using a 5x magnifier. The mean P duration before exercise in the control group was 107 +/- 16 ms (+/- 1 standard deviation) and 111 +/- 15 ms at the third minute of recovery, (p less than 0.001). In patients with CAD it was 112 +/- 12 and 129 +/- 19 ms (+/- 1 standard deviation), p less than 0.001, respectively. Differences in P-wave duration were found to be statistically significant (p less than 0.001) throughout recovery in the group with CAD when compared with control and maximal values at the third minute. The increase in P-wave duration (greater than or equal to 20 ms) was used as an additional parameter to exercise-induced ST-segment depression, ST elevation, or anginal pain for the test interpretation. The sensitivity increased from 57 to 75% and the specificity decreased from 85 to 77%.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
M M Myrianthefs; M H Ellestad; R H Startt-Selvester; R Crump
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  68     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1991 Dec 
Date Detail:
Created Date:  1992-01-16     Completed Date:  1992-01-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1619-24     Citation Subset:  AIM; IM    
Affiliation:
Memorial Heart Institute, Long Beach Memorial Medical Center, California 90801-1428.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angina Pectoris / physiopathology
Cohort Studies
Coronary Angiography*
Coronary Artery Disease / physiopathology
Coronary Disease / diagnosis,  physiopathology*,  radiography
Electrocardiography / methods*
Exercise Test*
Female
Humans
Male
Middle Aged
Retrospective Studies
Sensitivity and Specificity
Time Factors
Ventricular Function, Left / physiology

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


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