title: [Changes in R wave voltage during exercise: are they a sign of changes in ventricular volume or of myocardial ischemia?].
abstract: In an attempt to assess the significance of R wave amplitude changes during exercise in patients with coronary artery disease, we retrospectively analysed radionuclide as well as exercise test results of 147 patients with either suspected or already ascertained coronary artery disease, 126 men and 21 women, whose mean age was 56.0 +/- 9.3 years, 56 of which with previous myocardial infarction (16 on the anterior, 33 on the inferior and 7 on the lateral wall), who underwent a simultaneous evaluation of regional ventricular function by means of first pass angiography with multielement gamma-camera and of myocardial perfusion by means of single photon emission computerized tomography. All patients received 2 iv injections of 99mTc-methoxy-isobutyl-isonitrile at rest and at peak of a computerized bicycle stress test, whose end-points were ST segment depression greater than or equal to 1 mm or the attainment of a heart rate greater than 85% of maximal age-predicted one. R wave amplitude was measured by means of a magnifying lens on an averaged ECG complex, selecting for each patient the precordial lead showing the largest R wave amplitude. Absolute values of left ventricular volumes were computed by means of a standardized method from first pass angiography data. Patients were divided in subgroups according to the presence and to the number of coronary territories with evidence of stress-induced myocardial ischemia at radionuclide study.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: II Cattedra Malattie Apparato Cardiovascolare, Università degli Studi La Sapienza, Roma.
authors.forename: M
authors.initials: M
authors.lastname: Ciavolella
authors.forename: M
authors.initials: M
authors.lastname: Schiariti
authors.forename: E
authors.initials: E
authors.lastname: Cerquetani
authors.forename: C
authors.initials: C
authors.lastname: Ciani
authors.forename: C
authors.initials: C
authors.lastname: Giannitti
authors.forename: D
authors.initials: D
authors.lastname: Scali
authors.forename: F
authors.initials: F
authors.lastname: Sciarra
authors.forename: N
authors.initials: N
authors.lastname: Schad
authors.forename: A
authors.initials: A
authors.lastname: Reale
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging
vernacular_title: Modificazioni di voltaggio dell'onda R sotto sforzo: indice di variazione dei volumi ventricolari o di ischemia miocardica?