Evaluation of R wave amplitude changes versus ST-segment depression in stress testing

Circulation
P E BonorisM H Ellestad

Abstract

Exercise ECGs and coronary angiograms were reviewed in 266 patients (81 normals and 185 with significant coronary artery disease). Thirty-three false positive and 96 false negative ST responses to stress testing were purposely chosen to determine if the R wave could reduce the number of false ST responses. R wave amplitude changes were measured in the control and in the immediate postexercise period. An increase or no change in R wave was taken as evidence of an abnormal response, while a decrease in the R wave was a normal response. The sensitivity by ST segment was 48% and the specificity was 59%. These values were low because of the large number of false positive and negative ST responses in the study. It was our purpose to determine if these lowered values could be significantly improved by the R wave. Using R wave criteria, the sensitivity was 63% (P is less than 0.01) while the specificity was 79% (P is less than 0.01). The sensitivity and specificity of stress testing can be significantly improved using R wave changes.

References

Aug 21, 1975·The New England Journal of Medicine·J S BorerS E Epstein
Feb 1, 1978·The American Journal of Cardiology·J P Cole, M H Ellestad
Feb 1, 1972·American Heart Journal·H V PipbergerA S Berson
Sep 1, 1974·British Heart Journal·B SharmaS H Taylor
Mar 1, 1969·Progress in Cardiovascular Diseases·R A Bruce, T R Hornsten
Jul 1, 1972·Circulation Research·C V NelsonP G Hugenholtz
Nov 1, 1971·Progress in Cardiovascular Diseases·M V Herman
Jul 1, 1971·American Heart Journal·M ManoachS Gassner
Jul 1, 1961·American Heart Journal·C V NelsonH H HECHT

Citations

Mar 1, 1996·Clinical Cardiology·E PetrucciM Bertinelli
Jul 1, 1985·Medical & Biological Engineering & Computing·A PeperC A Grimbergen
Mar 1, 1990·Medical & Biological Engineering & Computing·A PeperJ Strackee
Dec 1, 1979·The American Journal of Cardiology·S WagnerA Selzer
Jun 1, 1985·The American Journal of Cardiology·J G Heaf
Jan 1, 1982·International Journal of Cardiology·R A WolthuisV F Froehlicher
Dec 1, 1990·International Journal of Psychophysiology : Official Journal of the International Organization of Psychophysiology·M Myrtek
Sep 1, 1993·Journal of the American College of Cardiology·D J CallansF E Marchlinski
Oct 7, 1998·The American Journal of Cardiology·N S IbrahimM H Ellestad
Jul 1, 1996·Journal of Electrocardiology·D M Mirvis
Dec 1, 1983·Journal of the American College of Cardiology·L VanHeesA Amery
Mar 1, 1984·Journal of the American College of Cardiology·J A HopkirkJ Fischer
Sep 1, 1985·Journal of the American College of Cardiology·J MyersM Sullivan
Nov 1, 1992·Pacing and Clinical Electrophysiology : PACE·S E GreenhutL A DiCarlo
Oct 1, 1980·British Heart Journal·V BalasubramanianE B Raftery
Jan 1, 1983·British Heart Journal·J E DeanfieldK Fox
Oct 2, 2004·Circulation Journal : Official Journal of the Japanese Circulation Society·Satoru SakuragiKenji Sunagawa
Mar 21, 2008·Journal of Electrocardiology·Mohamad C N SinnoSanjaya Khanal
Nov 1, 2001·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·A TothK Toth
Sep 22, 2007·Journal of Electrocardiology·Tatsuya KawasakiHiroki Sugihara
Apr 1, 1982·Journal of Electrocardiology·A S IskandrianB L Segal
Oct 1, 1985·Journal of Electrocardiology·D D McPhersonT J Montague
Apr 6, 1999·The American Journal of Cardiology·S L ChengR H Selvester
Nov 1, 1980·The American Journal of Cardiology·M C GersonP L McHenry
Feb 1, 1987·IEEE Transactions on Bio-medical Engineering·O Pahlm, L Sörnmo
Nov 1, 1979·IEEE Transactions on Bio-medical Engineering·R A WolthuisJ R Fischer
Jun 1, 1981·The American Journal of Cardiology·B R Chaitman, J S Hanson
Dec 31, 1997·Journal of Cardiothoracic and Vascular Anesthesia·J V Aittomäki, M T Salmenperä
Apr 1, 1990·The American Journal of Cardiology·E A RossV Froelicher
Nov 1, 1989·Progress in Cardiovascular Diseases·R DetranoV Froelicher
Dec 1, 1980·The American Journal of Cardiology·D M Mirvis
May 1, 1979·Progress in Cardiovascular Diseases·M H EllestadP S Greenberg
Jul 1, 1982·The American Journal of Cardiology·B FalknerB Hamstra
Mar 1, 1982·The American Journal of Cardiology·K FoxA P Selwyn
Apr 1, 1987·Current Problems in Cardiology·G J Dehmer
Jun 1, 1984·International Journal of Cardiology·C van TellingenR D Rijneke
Jul 1, 1984·International Journal of Cardiology·M J O'HaraE B Raftery
Jul 1, 1993·Journal of Electrocardiology·A P MichaelidesP K Toutouzas
Jan 1, 1981·Journal of Electrocardiology·K WatanabeV Froelicher
Jan 1, 1980·Journal of Electrocardiology·P S GreenbergM H Ellestad
Jan 1, 1982·Annals of the New York Academy of Sciences·J Erikssen, R Mundal
Dec 1, 1980·Journal of Adolescent Health Care : Official Publication of the Society for Adolescent Medicine·C M CottrillT Kotchen
Feb 1, 1983·The American Journal of Cardiology·M A FamularoM H Ellestad
Feb 1, 1983·The American Journal of Cardiology·B FalknerB Hamstra
Aug 1, 1990·American Heart Journal·A P MichaelidesP K Toutouzas
Jul 1, 1984·The American Journal of Cardiology·R D WiensH L Kennedy
Jul 1, 1979·The American Journal of Cardiology·P S GreenbergM H Ellestad
Jun 27, 2007·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Abdenasser DrighilBeenyouness Ramdani
May 1, 1982·Acta Medica Scandinavica·S YusufA Hjalmarson
Mar 1, 2000·Journal of Cardiovascular Electrophysiology·B Surawicz
Feb 19, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Masakazu YamagishiJapanese Circulation Society Working Group

Related Concepts

Related Feeds

Cardiology Journals

Discover the latest cardiology research in this collection of the top cardiology journals.