Diagnostic value of maximal treadmill exercise electrocardiogram in predicting coronary artery disease for asymptomatic Chinese male subjects.
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.
Ding
Y A
YA
Department of Cardiology, Tri-Service General Hospital, Taipei, Taiwan, Republic of China.
Shieh
S M
SM
Chen
C Y
CY
Wang
D J
DJ
Sung
P K
PK
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
D013794:Thallium Radioisotopes