Advanced

ST-recovery loop of exercise-induced ST deviation in the identification of coronary artery disease: Which parameters should we measure?

Svensbergh, A; Johansson, M; Pahlm, Olle LU and Brudin, LH (2004) In Journal of Electrocardiology 37(4). p.275-283
Abstract
This study aimed to characterize the ST-recovery loop and assess which range of heart rates (HRs) best discriminates between patients with and without significant coronary artery stenosis. Bicycle exercise tests were undertaken in 44 men and IS women with coronary artery disease (CAD) and in 59 controls (26 men, 33 women) in the same age range with no signs of CAD. The ST level and the ST-segment slope were continuously monitored, and changes from rest to peak exercise and to 4 min after exercise, respectively, were calculated. Plotting the ST level against HR gives the STHR loop, characterized by the normalized area (NA(alpha)) circumscribed by the ST level during and after exercise from alpha% to 100% of the HR range. Eight values of a... (More)
This study aimed to characterize the ST-recovery loop and assess which range of heart rates (HRs) best discriminates between patients with and without significant coronary artery stenosis. Bicycle exercise tests were undertaken in 44 men and IS women with coronary artery disease (CAD) and in 59 controls (26 men, 33 women) in the same age range with no signs of CAD. The ST level and the ST-segment slope were continuously monitored, and changes from rest to peak exercise and to 4 min after exercise, respectively, were calculated. Plotting the ST level against HR gives the STHR loop, characterized by the normalized area (NA(alpha)) circumscribed by the ST level during and after exercise from alpha% to 100% of the HR range. Eight values of a between 20% and 90% were investigated, and chest and extremity leads were investigated separately. Optimal a was found to be less than or equal to70% in men and less than or equal to30% in women. Change in ST-segment slope was the only parameter that gave significant additional discriminating power in both men and women once the area had been taken into account. We conclude that NA(alpha) for extremity and chest leads have similar weights, and that a substantial part of the STHR loop should be taken into consideration, especially in women. NA(3O) was superior to end-exercise ST-depression and STHR loop orientation (as defined by the sign of NA(90) in both men and women, and to ST/HR index in men, in identifying CAD. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
multivariate analysis, ECG, stress test
in
Journal of Electrocardiology
volume
37
issue
4
pages
275 - 283
publisher
Elsevier
external identifiers
  • pmid:15484155
  • wos:000225303900004
  • scopus:5144235127
ISSN
1532-8430
DOI
10.1016/j.jelectrocard.2004.07.012
language
English
LU publication?
yes
id
ba026b5a-2500-4bcc-9993-2e79d616642b (old id 259854)
date added to LUP
2007-11-02 10:56:55
date last changed
2017-01-01 04:49:36
@article{ba026b5a-2500-4bcc-9993-2e79d616642b,
  abstract     = {This study aimed to characterize the ST-recovery loop and assess which range of heart rates (HRs) best discriminates between patients with and without significant coronary artery stenosis. Bicycle exercise tests were undertaken in 44 men and IS women with coronary artery disease (CAD) and in 59 controls (26 men, 33 women) in the same age range with no signs of CAD. The ST level and the ST-segment slope were continuously monitored, and changes from rest to peak exercise and to 4 min after exercise, respectively, were calculated. Plotting the ST level against HR gives the STHR loop, characterized by the normalized area (NA(alpha)) circumscribed by the ST level during and after exercise from alpha% to 100% of the HR range. Eight values of a between 20% and 90% were investigated, and chest and extremity leads were investigated separately. Optimal a was found to be less than or equal to70% in men and less than or equal to30% in women. Change in ST-segment slope was the only parameter that gave significant additional discriminating power in both men and women once the area had been taken into account. We conclude that NA(alpha) for extremity and chest leads have similar weights, and that a substantial part of the STHR loop should be taken into consideration, especially in women. NA(3O) was superior to end-exercise ST-depression and STHR loop orientation (as defined by the sign of NA(90) in both men and women, and to ST/HR index in men, in identifying CAD.},
  author       = {Svensbergh, A and Johansson, M and Pahlm, Olle and Brudin, LH},
  issn         = {1532-8430},
  keyword      = {multivariate analysis,ECG,stress test},
  language     = {eng},
  number       = {4},
  pages        = {275--283},
  publisher    = {Elsevier},
  series       = {Journal of Electrocardiology},
  title        = {ST-recovery loop of exercise-induced ST deviation in the identification of coronary artery disease: Which parameters should we measure?},
  url          = {http://dx.doi.org/10.1016/j.jelectrocard.2004.07.012},
  volume       = {37},
  year         = {2004},
}