Evaluation of ST-segment changes during and after maximal exercise tests in one-, two- and three-vessel coronary artery disease.
OBJECTIVE
To relate ECG and heart rate (HR) variables during and after exercise testing with the presence of one-, two- or three-vessel disease defined by angiography.


METHODS
Seventy-three male patients with stable angina pectoris and angiographically verified coronary artery disease underwent a maximal exercise test. From 12-lead ECG recordings and computer averaging ST-amplitude and HR data were measured in consecutive 10-s intervals.


RESULTS
In univariate analysis, patients with three-vessel disease had lower maximal exercise capacity, a shorter time to >1 mm ST-depression, more often a clockwise ST/HR recovery loop, more frequently a post-exercise downward ST-segment slope, and a greater ST-deficit at 3.5 min after exercise than patients with one-vessel disease. In multivariate analysis, time to >1 mm ST-depression discriminated between patients with three- and one-vessel disease. In patients with an intermediate time to >1 mm ST-depression a clockwise ST/HR recovery loop and/or a downsloping ST-segment in the post-exercise period were significantly more prevalent in severe vessel disease.


CONCLUSIONS
Patients with three-vessel disease had a significantly shorter time to >1 mm ST-depression during exercise and more often an abnormal post-exercise ST/HR reaction than those with one-vessel disease.
Bjurö
Thorvald
T
AstraZeneca R&D, Mölndal, Sweden. thorvald.bjuro@astrazeneca.com
Gullestad
Lars
L
Endresen
Knut
K
Nordlander
Margareta
M
Malm
Anders
A
Höglund
Lena
L
Wahlqvist
Inger
I
Pernow
John
J
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000145:classification / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D013318:Stroke Volume; D013997:Time Factors