Document Detail


Value of leads V4R and CM5 in the detection of coronary artery disease during exercise electrocardiographic test.
MedLine Citation:
PMID:  20497446     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The usefulness of the right precordial unipolar leads and the value of the bipolar lead CM5 in the detection of coronary artery disease (CAD) with exercise electrocardiographic (ECG) test are not well documented. The objective of this study was to evaluate the diagnostic performance of leads V4R and CM5. The study population comprised 579 patients referred for a bicycle exercise ECG test in the Finnish Cardiovascular Study. Patients were divided into three groups: angiographically proven CAD (CAD, n = 255), no CAD by angiography (NoCAD, n = 126), and low likelihood of CAD (LLC, n = 198). The maximum ST-segment depression at peak exercise was used as a parameter, and the diagnostic accuracy of different leads was assessed by receiver operating characteristic (ROC) analysis. Sensitivity and specificity values at a cut-off criterion of -0.10 mV ST-segment, 1-mm ST depression, were determined. According to the results, incorporating lead V4R with the standard leads decreased the ROC area from 0.71 to 0.69 (comparison CAD versus LLC) and from 0.55 to 0.53 (comparison CAD versus NoCAD) and had no effect on sensitivity or specificity. Adding lead CM5 to the standard leads did not affect the ROC area but increased the sensitivity and decreased the specificity. In conclusion, the use of right precordial lead V4R along with the standard 12-lead system does not improve the performance of the exercise ECG in diagnosing CAD. Adding lead CM5 to the standard leads increases the sensitivity but does not change the overall diagnostic performance.
Authors:
Merja Puurtinen; Tuomo Nieminen; Mika Kähönen; Terho Lehtimäki; Rami Lehtinen; Kjell Nikus; Jari Hyttinen; Jari Viik
Related Documents :
6286906 - Comparison of cold pressor and exercise radionuclide angiocardiography in coronary arte...
3732306 - The (f)utility of the thallium-201 quantitative lung/myocardial ratio in the detection ...
10827376 - Clinical importance of risk factors and exercise testing for prediction of significant ...
6673826 - Systolic time-interval evaluation by thermistor plethysmography during uninterrupted dy...
3759786 - Lactate and ventilatory thresholds: disparity in time course of adaptations to training.
7132646 - The effects of hypercapnia on the metabolic response to steady-state exercise.
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-05-24
Journal Detail:
Title:  Clinical physiology and functional imaging     Volume:  30     ISSN:  1475-097X     ISO Abbreviation:  Clin Physiol Funct Imaging     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-28     Completed Date:  2010-11-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137604     Medline TA:  Clin Physiol Funct Imaging     Country:  England    
Other Details:
Languages:  eng     Pagination:  308-12     Citation Subset:  IM    
Affiliation:
Department of Biomedical Engineering, Tampere University of Technology, Tampere, Finland. merja.puurtinen@uta.fi
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography
Coronary Artery Disease / diagnosis*,  radiography
Electrocardiography* / instrumentation
Electrodes
Exercise Test*
Female
Finland
Humans
Male
Middle Aged
Predictive Value of Tests
ROC Curve
Sensitivity and Specificity

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


Previous Document:  Muscle tissue oxygenation and VEGF in VO-matched vibration and squatting exercise.
Next Document:  Lung aeration during sleep in patients with obstructive sleep apnoea.