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[A comparative study on coronary angiography and exercise ECG testing]
Insights
Exercise ECG testing can help diagnose coronary artery disease (CAD) and assess its severity. Specific ST segment changes during exercise predict CAD, with higher positive rates for multi-vessel disease.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Exercise Physiology
Background:
- Coronary artery disease (CAD) diagnosis relies on various methods.
- Exercise electrocardiogram (ECG) testing is a non-invasive tool for assessing cardiac function during physical stress.
Purpose of the Study:
- To evaluate the diagnostic accuracy of exercise ECG testing for coronary artery disease.
- To determine the correlation between exercise ECG parameters and the severity of coronary artery disease.
Main Methods:
- A comparative study involving 461 patients undergoing both coronary angiography and exercise ECG testing.
- Analysis of ST segment depression (≥0.1 mV and ≥0.2 mV) and its correlation with coronary artery disease presence and extent.
Main Results:
- Exercise ECG testing demonstrated a sensitivity of 74.5% and specificity of 84.2% for predicting coronary artery disease.
- A threshold of ST depression >0.2 mV showed 61.3% sensitivity and 79.1% specificity for predicting triple-vessel and left main coronary artery disease.
- Workload, systolic blood pressure increment, and ST depression duration correlated with the number of diseased coronary arteries.
Conclusions:
- Exercise ECG testing is valuable for diagnosing coronary artery disease and predicting its severity.
- Specific exercise parameters, including ST segment changes, aid in assessing CAD extent.
- Female patients exhibited a higher false-positive rate compared to males.
Abstract:
Both coronary angiography and exercise ECG testing were done in 461 patients. The comparative study showed that positive results of exercise ECG testing down-slope or horizontal depression of ST segment more than 0.1 mV during or after exercise may predict coronary artery disease, the sensitivity was 74.5% (322 cases) and specificity 84.2% (139 cases). With the use of ST depression more than 0.2 mV as the super-positive standard, the sensitivity and specificity of positive exercise ECG testing to predict triple vessel disease and left main coronary disease was 61.3% and 79.1%, respectively. The workload and the increment of systolic blood pressure had a negative correlation (r = -0.4531 and -0.3), but the duration of ST depression had a positive correlation (r = 0.4502) with the number of diseased coronary arteries. The patients with multi-vessel disease and left main coronary artery disease had a higher positive rate of exercise ECG testing as compared with the patients with single or double vessel disease. The female patients had a higher false positive rate than the male. It is concluded that exercise ECG testing has some value in diagnosing coronary artery disease and predicting its severity. Some parameters in exercise is helpful to predict the severity of coronary artery disease.