Significance of exercise-induced junctional S-T depression in evaluation of coronary artery disease.
Isolated junctional S-T depression induced during treadmill exercise testing was correlated with coronary arteriographic findings in 230 patients. Of 75 patients with junctional depression of less than 1.5 mm, 10 had 50% or greater stenosis of at least one major coronary artery and 2 patients (3%) had multivessel disease. Of 42 with junctional depression of 1.5 mm or more and a rapid upsloping S-T segment, 23 had 50% or greater coronary stenosis and 12 of these had multivessel disease. Of 35 with an upsloping pattern (junctional depression of more than 2 mm, upsloping S-T segment depressed 2 mm or more, 0.08 second after the J point), 33 (94%) had 50% or greater coronary stenosis compared with 46 (96%) and 30 (97%) with 2 mm or more junctional depression ahd a horizontal or downsloping S-T segment. In conclusion, multivessel disease is rare with isolated exercise-induced junctional depression of less than 1.5 mm but common when the J point is depressed 1.5 mm or more. Junctional depression of more than 2 mm is associated with the same incidence of coronary disease when the S-T segment is slowly ascending (upsloping pattern) as when it is horizontal.
D000328:Adult; D003251:Constriction, Pathologic / Q000175:diagnosis; D003327:Coronary Disease / Q000175:diagnosis* / Q000503:physiopathology; D003331:Coronary Vessels / Q000503:physiopathology; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction