Exercise-induced ST-segment elevation in leads aVR and V1 for the prediction of left main disease.
BACKGROUND
This study investigated the value of exercise-induced ST-segment elevation in lead aVR with or without concomitant ST-segment elevation in lead V(1) for detection of left main (LM) coronary artery disease in patients with Duke treadmill score <or=-11.


METHODS
One hundred and four patients with Duke treadmill score <or=-11 were retrospectively screened for presence of ST-segment elevation in lead aVR and lead V(1).


RESULTS
Twenty-six out of 65 patients with ST-segment elevation in lead aVR and 24 out 38 patients with ST-segment elevation in lead aVR with concomitant ST-segment elevation in lead V(1) were found to have LM disease. Exercise-induced ST-segment elevation in lead aVR had a sensitivity of 92.9% and a specificity of 48.6% and ST-segment elevation in lead aVR accompanied by ST-segment elevation in lead V(1) had a sensitivity of 85.7% and a specificity of 81.6% in predicting LM disease.


CONCLUSIONS
This study shows that the observation of exercise-induced ST-segment elevation in lead aVR is a sensitive, but not a specific, electrocardiographic finding of significant LM coronary artery disease. However, exercise-induced ST-segment elevation in lead aVR accompanied by ST-segment elevation in lead V(1) might be not only a sensitive but also a specific finding of LM stenosis in these patients.
Tuna Katircibaşi
M
M
Department of Cardiology, Faculty of Medicine, Başkent University, Dadaloğlu Mahallesi, 39 Sok No 6, 01250 Yuregir, Adana, Turkey. doktortuna@gmail.com
Tolga Koçum
H
H
Tekin
Abdullah
A
Erol
Tansel
T
Tekin
Göknur
G
Baltali
Mehmet
M
Müderrisoğlu
Haldun
H
D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis*; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity