Gender aspects on exercise-induced ECG changes in relation to scintigraphic evidence of myocardial ischaemia
(2018) In Clinical Physiology and Functional Imaging 38(5). p.798-807- Abstract
Background: This retrospective study aimed to determine the diagnostic performance of exercise-induced ST response in relation to findings by myocardial perfusion single photon emission computed tomography (MPS), with focus on gender differences, in patients with suspected or established stable ischemic heart disease. Methods: MPS findings of 1 021 patients (518 females) were related to the exercise-induced ST response alone (blinded and unblinded to gender) and ST response together with additional exercise stress test (EST) variables (exercise capacity, blood pressure and heart rate response). Results: Exercise-induced ischaemia by MPS was found in 9% of females and 23% of males. Diagnostic performance of exercise-induced ST response... (More)
Background: This retrospective study aimed to determine the diagnostic performance of exercise-induced ST response in relation to findings by myocardial perfusion single photon emission computed tomography (MPS), with focus on gender differences, in patients with suspected or established stable ischemic heart disease. Methods: MPS findings of 1 021 patients (518 females) were related to the exercise-induced ST response alone (blinded and unblinded to gender) and ST response together with additional exercise stress test (EST) variables (exercise capacity, blood pressure and heart rate response). Results: Exercise-induced ischaemia by MPS was found in 9% of females and 23% of males. Diagnostic performance of exercise-induced ST response in relation to MPS findings in females versus males was: sensitivity = 48%,70%; specificity = 67%, 64%; PPV = 13%, 38%; NPV = 93%, 87%. Adding more EST variables to the ST response interpretation yielded in females vs males: sensitivity = 44%, 51%; specificity = 84%, 83%; PPV = 22%, 48% and NPV = 93%, 85%. Conclusions: In patients who have performed EST in conjunction with MPS, there is a gender difference in the diagnostic performance of ST response at stress, with a significantly lower PPV in females compared to males. For both genders, specificity can be significantly improved, and a higher PPV can be obtained, while the sensitivity might be compromised by considering more EST variables, in addition to the ST response.
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- author
- Akil, Shahnaz LU ; Hede´n, Bo LU ; Pahlm, Olle LU ; Carlsson, Marcus LU ; Arheden, Håkan LU and Engblom, Henrik LU
- organization
- publishing date
- 2018-09
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Chronic myocardial ischaemia, Electrocardiography, Exercise, Gender, Myocardial perfusion SPECT
- in
- Clinical Physiology and Functional Imaging
- volume
- 38
- issue
- 5
- pages
- 798 - 807
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- pmid:29115010
- scopus:85033213921
- ISSN
- 1475-0961
- DOI
- 10.1111/cpf.12483
- language
- English
- LU publication?
- yes
- id
- baa317a6-6caa-4f53-a2a5-4fb22ee703ce
- date added to LUP
- 2017-12-12 15:56:06
- date last changed
- 2024-04-15 00:30:04
@article{baa317a6-6caa-4f53-a2a5-4fb22ee703ce,
abstract = {{<p>Background: This retrospective study aimed to determine the diagnostic performance of exercise-induced ST response in relation to findings by myocardial perfusion single photon emission computed tomography (MPS), with focus on gender differences, in patients with suspected or established stable ischemic heart disease. Methods: MPS findings of 1 021 patients (518 females) were related to the exercise-induced ST response alone (blinded and unblinded to gender) and ST response together with additional exercise stress test (EST) variables (exercise capacity, blood pressure and heart rate response). Results: Exercise-induced ischaemia by MPS was found in 9% of females and 23% of males. Diagnostic performance of exercise-induced ST response in relation to MPS findings in females versus males was: sensitivity = 48%,70%; specificity = 67%, 64%; PPV = 13%, 38%; NPV = 93%, 87%. Adding more EST variables to the ST response interpretation yielded in females vs males: sensitivity = 44%, 51%; specificity = 84%, 83%; PPV = 22%, 48% and NPV = 93%, 85%. Conclusions: In patients who have performed EST in conjunction with MPS, there is a gender difference in the diagnostic performance of ST response at stress, with a significantly lower PPV in females compared to males. For both genders, specificity can be significantly improved, and a higher PPV can be obtained, while the sensitivity might be compromised by considering more EST variables, in addition to the ST response.</p>}},
author = {{Akil, Shahnaz and Hede´n, Bo and Pahlm, Olle and Carlsson, Marcus and Arheden, Håkan and Engblom, Henrik}},
issn = {{1475-0961}},
keywords = {{Chronic myocardial ischaemia; Electrocardiography; Exercise; Gender; Myocardial perfusion SPECT}},
language = {{eng}},
number = {{5}},
pages = {{798--807}},
publisher = {{John Wiley & Sons Inc.}},
series = {{Clinical Physiology and Functional Imaging}},
title = {{Gender aspects on exercise-induced ECG changes in relation to scintigraphic evidence of myocardial ischaemia}},
url = {{http://dx.doi.org/10.1111/cpf.12483}},
doi = {{10.1111/cpf.12483}},
volume = {{38}},
year = {{2018}},
}