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Related Experiment Videos

ST segment changes post-infarction: predictive value for multivessel coronary disease and left ventricular aneurysm

D A Weiner, C McCabe, M D Klein

    Circulation
    |November 1, 1978
    PubMed
    Summary

    Exercise stress tests can predict multivessel coronary artery disease and left ventricular aneurysm after myocardial infarction. ST depression indicates multivessel disease, while ST elevation alone suggests single-vessel involvement.

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    Area of Science:

    • Cardiology
    • Exercise Physiology
    • Diagnostic Testing

    Background:

    • Myocardial infarction (MI) survivors require accurate risk stratification.
    • Exercise testing is a common non-invasive tool post-MI.
    • Predicting multivessel coronary artery disease (CAD) and left ventricular aneurysm (LVA) is crucial for management.

    Purpose of the Study:

    • To determine if exercise testing can predict multivessel CAD and LVA in post-MI patients.
    • To correlate specific electrocardiographic (ECG) changes during exercise with angiographic findings.

    Main Methods:

    • 154 post-MI patients underwent exercise testing and coronary angiography.
    • Patients were grouped based on ST-segment depression or elevation during exercise.
    • Multivessel CAD defined as ≥70% narrowing in ≥2 coronary vessels.

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    Main Results:

    • ST depression (with or without ST elevation) strongly predicted multivessel CAD (76-91% prevalence).
    • ST elevation alone or no ST changes indicated lower rates of multivessel CAD (13-21%).
    • ST elevation (with or without ST depression) was associated with a higher incidence of LVA (68-79%).

    Conclusions:

    • Exercise testing reliably predicts multivessel CAD and LVA post-MI.
    • ST depression patterns during exercise are key indicators of coronary artery disease extent.
    • Specific ST-segment changes during exercise testing offer valuable prognostic information.