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Gender aspects on exercise-induced ECG changes in relation to scintigraphic evidence of myocardial ischaemia

Akil, Shahnaz LU ; Hede´n, Bo LU ; Pahlm, Olle LU ; Carlsson, Marcus LU ; Arheden, Håkan LU and Engblom, Henrik LU (2017) In Clinical Physiology and Functional Imaging
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
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Chronic myocardial ischaemia, Electrocardiography, Exercise, Gender, Myocardial perfusion SPECT
in
Clinical Physiology and Functional Imaging
publisher
Wiley Online Library
external identifiers
  • 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
2018-05-29 11:29:14
@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},
  keyword      = {Chronic myocardial ischaemia,Electrocardiography,Exercise,Gender,Myocardial perfusion SPECT},
  language     = {eng},
  publisher    = {Wiley Online Library},
  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},
  year         = {2017},
}