[Coronary artery disease in hypertensive patients: improvement of the diagnostic value of exercise test by heart rate adjusted ST segment depression].
Hypertensive patients complaining of chest pain often have a normal coronary angiogram despite a pathological exercise tolerance test. The aim of the present study was to establish whether the prevalence of these "false-positive" tests could be lowered by adjusting ST segment depression for exercise-induced increase in heart rate.


METHODS
60 hypertensive patients, mean age 59 years, with typical or atypical chest pain, underwent both a symptom-limited exercise test and a coronary angiogram within a median period of 1 day. The ST segment depression was measured every 20 ms from the J point. A stepwise discriminant analysis was performed: a canonical variable took into account the Detrano index, the quantified rate-recovery loop index (QRL index) as well as the presence of a LV hypertrophy (Romhilt Estes Score).


RESULTS
[table: see text]


CONCLUSIONS
in hypertensive patients with chest pain, the specificity and the positive predictive value of exercise test are significantly improved by adjusting ST segment depression for heart rate both during effort and recovery and by taking into account the score of Romhilt Estes on the baseline ECG recording.
Herpin
D
D
Service de cardiologie B, CHU La-Milétrie Jean-Bernard, Poitiers.
Ferrandis
J
J
Gaudeau
B
B
Ragot
S
S
Le Henaff
J
J
Raud
P
P
Amiel
A
A
Demange
J
J
D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D004562:Electrocardiography; D005080:Exercise Test; D005189:False Positive Reactions; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000150:complications*; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity
Insuffisance coronarienne de l'hypertendu: amélioration de la valeur diagnostique de l'épreuve d'effort par ajustement du sous-décalage de ST à la fréquence cardiaque.