title: Diagnostic value of maximal treadmill exercise electrocardiogram in predicting coronary artery disease for asymptomatic Chinese male subjects.
abstract: The value of maximal treadmill exercise electrocardiogram (TEE) in predicting coronary artery disease was evaluated in a consecutive series of 168 asymptomatic Chinese males, aged 41 to 57 years (mean 53) during annual physical examinations. Their resting electrocardiograms (ECGs) showed no abnormal Q-waves. The end-point of TEE achieved the age-predicted maximal heart rate, and no subjects had classic angina pectoris during or after TEE. Thirty-five subjects had positive electrocardiographic changes defined as reversible horizontal or downsloping ST-segment depression greater than or equal to 1.0 mv which lasted greater than or equal to 0.08 sec. Exercise thallium-201 (T1-201) myocardial imaging was performed on all 35 subjects with positive TEE; 30 subjects (86%) demonstrated normal and 5 abnormal scintigrams. Sixteen of the 30 cases with normal T1-201 scans underwent coronary arteriography, of which 14 showed normal arteriograms and two showed a less than 49% stenosis of the luminal diameter in one major artery. Of the 5 cases with abnormal scintigrams, 4 were found to have greater than 50% stenoses in at least one major artery, and only one case had a less than 49% stenosis of the right coronary artery. We concluded that TEE alone for asymptomatic individuals provided limited value in diagnosing significant coronary artery disease, especially in areas of low prevalence.
authors.affiliation: Department of Cardiology, Tri-Service General Hospital, Taipei, Taiwan, Republic of China.
authors.forename: Y A
authors.initials: YA
authors.lastname: Ding
authors.forename: S M
authors.initials: SM
authors.lastname: Shieh
authors.forename: C Y
authors.initials: CY
authors.lastname: Chen
authors.forename: D J
authors.initials: DJ
authors.lastname: Wang
authors.forename: P K
authors.initials: PK
authors.lastname: Sung
mesh_terms: D000328:Adult; D003327:Coronary Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004562:Electrocardiography; D005080:Exercise Test; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D013624:Taiwan; D013794:Thallium Radioisotopes
chemical_list: D013794:Thallium Radioisotopes