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[The effort test in the diagnosis of typical stable effort angina (author's transl)]
Insights
Exercise stress tests accurately detect coronary artery disease, especially in men. The extent of coronary artery disease correlates with specific exercise test parameters like rate-pressure product.
Area of Science:
- Cardiology
- Diagnostic Medicine
- Exercise Physiology
Background:
- Typical effort angina often indicates significant coronary artery disease.
- Exercise testing is a common diagnostic tool for angina.
Purpose of the Study:
- To evaluate the diagnostic accuracy of exercise stress tests for coronary artery disease.
- To explore correlations between exercise test parameters and the extent of coronary artery disease.
Main Methods:
- 173 patients with typical effort angina underwent exercise testing and coronary angiography.
- Coronary angiography assessed significant stenosis (≥70%) in major coronary branches.
- Exercise test parameters were analyzed in relation to coronary findings.
Main Results:
- 93.1% of patients had significant coronary stenosis; sensitivity was 88.8%, rising to 94.3% with three-vessel disease.
- Positive exercise tests showed a 96.6% correlation with coronary lesions (true positives).
- Extent of coronary disease correlated with rate-pressure product and maximal ST-segment depression.
Conclusions:
- Exercise stress testing is highly sensitive for detecting coronary artery disease.
- Specific exercise parameters correlate with the severity of coronary artery disease, aiding in risk stratification.
Abstract:
Among 173 patients with typical effort angina (159 men and 14 women) which underwent exercise test and coronary angiography, significant stenosis (greater than or equal to 70%) of one or more of important coronary branches were present in 93,1% of the cases (96,3% among the males and 57% among the females). In the same group the exercise test sensitivity was 88,8%; when 3 coronary branches were involved the sensitivity rises to 94,3%. The 96,6% of patients with positive exercise test had coronary lesions too (true positives). We did not find any correspondence between the site of transient subendocardial ischemia occurred during the exercise test and coronary branch involved, when the stenosis was limited only one important coronary branch. Finally the researche of correlation between the entity of coronary disease (number of coronary vessels involved, entity of left ventricular contractility impairment) and behavior of patient during exercise test, evaluated with different parameters measured at the moment of stopping of exercise (heart rate and threshold work load, rate-pressure product, maximal downsloping of ST segment, different positivity criteria for exercise test) allowed us to show a good correlation only between the extent of coronary involvement and rate-pressure product or maximal downsloping of ST segment.