Diagnostic and prognostic value of ST segment depression limited to the recovery phase of exercise stress test.
OBJECTIVE
To investigate the diagnostic and prognostic value of ST segment depression limited to the recovery phase of an exercise stress test, as compared with that of ST segment depression appearing during exercise.


METHODS
Exercise stress test laboratory of a university hospital.


METHODS
Clinical and angiographic data were compared for 574 consecutive patients who developed ST segment depression during the active phase of an exercise test (group 1) and for 79 patients who developed ST segment depression only during the recovery phase of the exercise test (group 2).


RESULTS
There were no differences between the two groups in major clinical features. Significant coronary artery stenoses were found in 488 group 1 patients (85%) and in 62 group 2 patients (78%, p = 0.14). Three vessel or left main disease was found in 166 (29%) group 1 and in 14 (18%) group 2 patients (p = 0.045). At a median follow up of 55.3 months of 321 group 1 and 54 group 2 patients, there were no significant differences in major cardiac events between the groups (univariate relative risk 0.81, 95% confidence interval 0.25 to 2.68, p = 0.72).


CONCLUSIONS
The diagnostic and prognostic power of ST segment depression limited to the recovery phase of an exercise test is largely similar to that of ST segment depression induced during effort; thus, assessing ST segment depression during recovery can significantly improve the clinical information derived from exercise stress tests.
Lanza
G A
GA
Istituto di Cardiologia, Università Cattolica del Sacro Cuore, L.go A. Gemelli, 8, 00168 Rome, Italy. g.a.lanza@inwind.it
Mustilli
M
M
Sestito
A
A
Infusino
F
F
Sgueglia
G A
GA
Crea
F
F
D001794:Blood Pressure / Q000502:physiology; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D023921:Coronary Stenosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors