A comparison of methods of analysing exercise tests for diagnosis of coronary artery disease.
The diagnostic accuracy of the following methods of analysing exercise tests were evaluated: (a) the cumulative area of ST segment depression during exercise normalised for workload and heart rate (exercise score); (b) discriminant analysis of electrocardiographic exercise variables, workload, and symptoms; and (c) ST segment amplitude changes during exercise adjusted for heart rate. Three hundred and forty five men without a history of myocardial infarction were studied. One hundred and twenty three were apparently healthy. Less than half (170) had coronary artery disease. All had a normal electrocardiogram at rest. A Frank lead electrocardiogram was computer processed during symptom limited bicycle ergometry. The accuracy of the exercise score (a) was low (sensitivity 67%, specificity 90%). Discriminant analysis (b) and ST segment amplitude changes adjusted for heart rate (c) had excellent diagnostic characteristics (sensitivity 80%, specificity 90%), which were little affected by concomitant use of beta blockers. Both methods seem well suited for diagnostic application in clinical practice.
Deckers
J W
JW
Thoraxcenter, Academic Hospital Rotterdam, Dijkzigt, The Netherlands.
Rensing
B J
BJ
Tijssen
J G
JG
Vinke
R V
RV
Azar
A J
AJ
Simoons
M L
ML
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000175:diagnosis*; D016002:Discriminant Analysis; D004562:Electrocardiography; D005080:Exercise Test; D006339:Heart Rate; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D012680:Sensitivity and Specificity