title: Evaluation of exercise-induced Q-wave amplitude changes and their clinical value.
abstract: We studied the influence of exercise level, severity of coronary artery disease (CAD), presence of previous myocardial infarction (MI), anterior or diaphragmatic, on the clinical value of exertional Q wave changes (Delta-Q). We retrospectively evaluated the exercise electrocardiograms of 62 patients without angiographic evidence of CAD and 133 patients with CAD; 28 of them had single (SVD) and 105 multivessel disease (MVD). Forty-one patients had a previous diaphragmatic MI and 23 anterior. The sensitivity, specificity and predictive value of Delta-Q were compared to the ST criterion. The exercise level affected Delta-Q. ST and Delta-Q had similar specificity and predictive values. The extent of CAD did not affect the sensitivity of Delta-Q and this method was better than ST to detect SVD patients. The Delta-Q criterion was equally as efficient as ST in MVD patients without MI and with diaphragmatic MI. The loss of septal forces on resting electrocardiograms made useless Delta-Q analysis on patients with anterior MI. The improvement of sensitivity in SVD patients by Delta-Q might be of clinical value since these latter are frequently not diagnosed by the ST criterion.
authors.affiliation: Istituto di Medicina Interna, II Facolta' di Medicina e Chirurgia di Napoli, Italy.
authors.forename: L
authors.initials: L
authors.lastname: DeCaprio
authors.forename: L
authors.initials: L
authors.lastname: Ascione
authors.forename: S
authors.initials: S
authors.lastname: Cuomo
authors.forename: C
authors.initials: C
authors.lastname: Vigorito
authors.forename: A
authors.initials: A
authors.lastname: Brienza
authors.forename: D
authors.initials: D
authors.lastname: Acanfora
authors.forename: M
authors.initials: M
authors.lastname: Papa
authors.forename: A
authors.initials: A
authors.lastname: Donatiello
authors.forename: C
authors.initials: C
authors.lastname: Chieffo
authors.forename: F
authors.initials: F
authors.lastname: Rengo
mesh_terms: D000328:Adult; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis; D005082:Physical Exertion; D012189:Retrospective Studies