Analysis of exercise-induced R wave amplitude changes in detection of coronary artery disease in asymptomatic men

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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

G S Uhl, J A Hopkirk

    The American Journal of Cardiology
    |December 1, 1979
    PubMed

    Insights

    Increased R wave amplitude during exercise is a sensitive indicator for detecting coronary artery disease in asymptomatic men with left bundle branch block, suggesting potential left ventricular dysfunction.

    Area of Science:

    • Cardiology
    • Exercise Physiology
    • Diagnostic Imaging

    Background:

    • Left bundle branch block (LBBB) can complicate electrocardiogram (ECG) interpretation.
    • Asymptomatic individuals with LBBB require reliable methods for coronary artery disease (CAD) screening.

    Purpose of the Study:

    • To evaluate the utility of exercise-induced R wave amplitude changes in detecting CAD in asymptomatic men with acquired LBBB.
    • To correlate R wave amplitude changes with angiographic findings and left ventricular function.

    Main Methods:

    • Analysis of exercise electrocardiograms (ECGs) in 44 asymptomatic men with acquired LBBB.
    • Correlation of ECG findings with selective coronary angiography results.
    • Assessment of left ventricular dysfunction using wall motion abnormalities and left ventricular end-diastolic pressure.

    Main Results:

    • An increase in R wave amplitude during exercise was observed in all 7 men with significant CAD (Group I) but only 10 of 37 men without CAD (Group II).
    • This criterion demonstrated 100% sensitivity, 73% specificity, 41% predictive value, and 77% accuracy for CAD diagnosis.
    • Greater increases in R wave amplitude correlated with left ventricular dysfunction.

    Conclusions:

    • Exercise-induced R wave amplitude increase is a highly sensitive marker for CAD in asymptomatic men with LBBB.
    • This ECG finding may indicate underlying left ventricular dysfunction in this population.

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