Περίληψη:
Background Exercise electrocardiography is an imperfect test for the
detection of coronary artery disease. We attempted to improve the
diagnostic accuracy of exercise testing as a noninvasive method for the
detection of coronary artery disease by using a combination of the left
and right precordial leads.
Methods We studied 245 patients (218 men and 27 women) ranging from 32
to 74 years of age (mean [+/-SD], 52 +/- 8) who underwent treadmill
exercise testing, thallium-201 scintigraphy, and coronary arteriography.
During exercise testing, each patient had one electrocardiogram recorded
with the standard 12 leads and 3 right precordial leads (V3R, V4R, and
V5R), with the results for each set of leads recorded and analyzed
separately.
Results On the basis of coronary arteriography, 34 patients had normal
coronary arteries, 85 had single-vessel disease, 84 had two-vessel
disease, and 42 had three-vessel disease. The sensitivities of the
standard 12-lead exercise electrocardiogram, exercise
electrocardiography incorporating right precordial leads, and
thallium-201 scintigraphy were 52 percent, 89 percent, and 87 percent,
respectively, for the detection of single-vessel disease; 71 percent, 94
percent, and 96 percent for the detection of two-vessel disease; 83
percent, 95 percent, and 98 percent for the detection of three-vessel
disease; and 66 per cent, 92 percent, and 93 percent for the detection
of any coronary artery disease. The specificities of the three methods
for the detection of any coronary artery disease were 88 percent, 88
percent, and 82 percent, respectively.
Conclusions Use of right precordial leads along with the standard six
left precordial leads during exercise electrocardiography greatly
improves the sensitivity of exercise testing for the diagnosis of
coronary artery disease. (N Engl J Med 1999;340:340-5.) (C) 1999,
Massachusetts Medical Society.
Συγγραφείς:
Michaelides, AP
Psomadaki, ZD
Dilaveris, PE
Richter, DJ and
Andrikopoulos, GK
Aggeli, KD
Stefanadis, CI
Toutouzas, PK
