Relation between electrocardiographic and scintigraphic location of myocardial ischemia during exercise in one-vessel coronary artery disease.
The purpose of this study was to determine the usefulness of exercise electrocardiography in predicting the site of myocardial ischemia. Fifty-two patients were studied who had angiographically documented 1-vessel coronary artery disease (CAD) and exercise-induced reversible thallium-201 perfusion defects. The patients were divided into 2 groups: group I (28 patients) had left anterior descending CAD and group II (24 patients) had left circumflex or right CAD. There were no significant differences between the 2 groups in severity of coronary stenosis, heart rate and systolic blood pressure during exercise. The size of the perfusion defect was larger in group I than II (28 +/- 12% vs 19 +/- 10%, p less than 0.02). There was no significant difference between the 2 groups in the frequency of ST depression in the anterior, inferior or lateral electrocardiographic leads. ST depression occurred in 16 patients (57%) in group I and 11 patients (46%) in group II (difference not significant). The sensitivity of the exercise electrocardiogram was 52% using 12 leads, 50% using 3 leads (V3, V5 and aVF) and 50% using V5 alone (difference not significant). Thus, the site of ST depression during exercise is not a good predictor of the site of exercise-induced perfusion defect or anatomic site of CAD. The use of 12 leads does not improve the sensitivity of exercise electrocardiography in patients with CAD.
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011868:Radioisotopes; D011877:Radionuclide Imaging; D013793:Thallium
D011868:Radioisotopes; D013793:Thallium