Aortic valve disease and the ST segment/heart rate relationship: a longitudinal study before and after aortic valve replacement.
The ST segment/heart rate relationship or maximal ST/HR slope has been validated as an index of myocardial ischemia in selected populations of patients with angina pectoris. The present study involved patients selected as having aortic valve disease unaccompanied by angiographic coronary artery narrowing. In each of seven patients, so far examined, a slope value and ST segment depression of greater than 1 mm were obtained which, according to previous experience, indicated myocardial ischemia equivalent to coronary heart disease. After aortic valve replacement, there was a significant reduction in heart size as assessed using the cardiothoracic ratio, and the amplitude of QRS complex on the electrocardiogram. The slope was abolished (two patients) or markedly reduced (five patients), and the decrease in the seven patients was statistically significant. ST segment depression could be obtained in one patient. This study has shown the occurrence of maximal ST/HR slope in patients without large coronary artery disease who have aortic valve disease and cardiac enlargement.
Bishop
N
N
Department of Cardiovascular Studies, University of Leeds, U.K.
Boyle
R M
RM
Watson
D A
DA
Stoker
J B
JB
Mary
D A
DA
D001021:Aortic Valve; D001022:Aortic Valve Insufficiency / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D006332:Cardiomegaly / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D004562:Electrocardiography; D005080:Exercise Test; D006339:Heart Rate; D006350:Heart Valve Prosthesis; D006801:Humans; D008137:Longitudinal Studies