title: [Electrocardiographic score: application in exercise test for the assessment of ischemic preconditioning].
abstract: BACKGROUND
  the time for 1.0 mm ST-segment depression (T-1.0mm) adopted to characterize ischemic preconditioning (IPC) in sequential exercise tests is consistent and reproducible; however, it has several limitations.
  
  
  OBJECTIVE
  to apply an electrocardiographic score of myocardial ischemia in sequential exercise tests, comparing it to the conventional T-1.0 mm index.
  
  
  METHODS
  sixty one patients with mean age of 62.2 ± 7.5 years were evaluated; 86.9% were males. A total of 151 tests were analyzed, 116 of which were from patients who completed two assessment phases. The first phase comprised two sequential exercise tests for the documentation of IPC; the second phase, initiated one week later, comprised two more tests carried out under the effect of repaglinide. Two observers who were blind to the tests applied the score.
  
  
  RESULTS
  Perfect inter and intraobserver agreement was found (Kendall tau-b = 0.96, p < 0.0001, and Kendall tau-b = 0.98, p < 0.0001, respectively). Values of sensitivity and specificity, negative predictive value, positive predictive value and accuracy were 72.41%, 89.29%, 75.8%, 87.5% and 81.0%, respectively.
  
  
  CONCLUSIONS
  the ischemic score is a consistent and reproducible method for the documentation of IPC, and is a feasible alternative to T-1.0 mm.
authors.affiliation: Instituto do Coração, HCFMUSP, São Paulo, SP, Brasil. augustohiroshi@cardiol.br
authors.forename: Augusto
authors.initials: A
authors.lastname: Uchida
authors.forename: Paulo
authors.initials: P
authors.lastname: Moffa
authors.forename: Whady
authors.initials: W
authors.lastname: Hueb
authors.forename: Luiz Antonio Machado
authors.initials: LA
authors.lastname: Cesar
authors.forename: Beatriz Moreira Ayub
authors.initials: BM
authors.lastname: Ferreira
authors.forename: Jose Antonio Franchini
authors.initials: JA
authors.lastname: Ramires
mesh_terms: D002219:Carbamates; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000503:physiopathology*; D004311:Double-Blind Method; D004562:Electrocardiography / Q000379:methods* / Q000592:standards; D016552:Ergometry; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D019194:Ischemic Preconditioning; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis*; D015588:Observer Variation; D010880:Piperidines; D011237:Predictive Value of Tests
chemical_list: D002219:Carbamates; D007004:Hypoglycemic Agents; D010880:Piperidines; C072379:repaglinide