Post-exercise response of the systolic blood pressure in the diagnosis of coronary artery disease: comparison of two exercise methods.
We studied 81 angiographically documented coronary artery disease patients and 28 with normal coronary arteries, having paired exercise tests (the Bruce treadmill protocol and the jogging in place test) in order to investigate the value of the ratio of recovery systolic blood pressure to peak exercise systolic blood pressure (postexercise pressure ratio) compared to the classic ST depression. The postexercise pressure ratio was significantly higher in patients with coronary artery disease than in patients with normal coronary arteries for each of the 2 exercise tests (P less than 0.001--P less than 0.00001). On the contrary, we obtained significantly lower sensitivities for the pathologic (greater than mean +/- 2 SD of patients with normal coronary arteries) values of the post-exercise pressure ratio than for the positive electrocardiographic outcome 30% vs 58% (P less than 0.00002) and 37% vs 64% (P less than 0.0001) as well as lower accuracies 48% vs 63% (P less than 0.03) and 52% vs 71% (P less than 0.005), respectively. Thus, we proved that the classic ST depression has much more diagnostic value than the post-exercise pressure ratio and this result is independent of the exercise methodology. Consequently this ratio is not recommended to replace the electrocardiographic exercise criteria.
Papazoglou
N
N
Cardiac Department, First Social Security Hospital, Athens, Greece.
Stagou
M
M
Gionakis
G
G
Kelermenos
N
N
Vitakis
S
S
Loussidis
P
P
Mantzouratos
D
D
D000792:Angiography; D001794:Blood Pressure / Q000502:physiology*; D003327:Coronary Disease / Q000175:diagnosis*; D004562:Electrocardiography; D015444:Exercise; D005260:Female; D006334:Heart Function Tests; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D013223:Statistics as Topic; D013599:Systole / Q000502:physiology