Can myocardial ischemia be recognized by the exercise electrocardiogram in coronary disease patients with abnormal resting Q waves?

Staffan Ahnve; Marios Savvides; Sleiman Abouantoun; J. Edwin Atwood; Victor Froelicher

doi:10.1016/0002-8703(86)90641-1

Can myocardial ischemia be recognized by the exercise electrocardiogram in coronary disease patients with abnormal resting Q waves?

Staffan Ahnve, Marios Savvides, Sleiman Abouantoun, J. Edwin Atwood, Victor Froelicher^*

^*Corresponding author for this work

Medicine

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Abstract

This study was performed in order to determine whether exercise-induced myocardial ischemia demonstrated by thallium-201 imaging could be detected by ST segment shifts in patients with abnormal Q waves at rest. Fifty-four patients with coronary artery disease and exercise-induced thallium-201 defects were compared to 22 patients with similar Q wave patterns but without thallium-201 exercise defects and to 14 normal subjects. Exercise data were analyzed visually in the 12-lead ECG and for spatial ST vector shifts. Both ST segment depression observed on the 12-lead ECG and spatial criteria were reasonably sensitive and specific for ischemia when the resting ECG showed no Q waves or inferior Q waves (range 69% to 93%). However, when anterior Q waves were present, ST segment shifts could not distinguish patients with ischemia from those with normal perfusion as determined by thallium imaging.

Original language	English
Pages (from-to)	909-916
Number of pages	8
Journal	American Heart Journal
Volume	111
Issue number	5
DOIs	https://doi.org/10.1016/0002-8703(86)90641-1
State	Published - May 1986

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10.1016/0002-8703(86)90641-1

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@article{3b23fb308602429ebc12a32a68209874,

title = "Can myocardial ischemia be recognized by the exercise electrocardiogram in coronary disease patients with abnormal resting Q waves?",

abstract = "This study was performed in order to determine whether exercise-induced myocardial ischemia demonstrated by thallium-201 imaging could be detected by ST segment shifts in patients with abnormal Q waves at rest. Fifty-four patients with coronary artery disease and exercise-induced thallium-201 defects were compared to 22 patients with similar Q wave patterns but without thallium-201 exercise defects and to 14 normal subjects. Exercise data were analyzed visually in the 12-lead ECG and for spatial ST vector shifts. Both ST segment depression observed on the 12-lead ECG and spatial criteria were reasonably sensitive and specific for ischemia when the resting ECG showed no Q waves or inferior Q waves (range 69% to 93%). However, when anterior Q waves were present, ST segment shifts could not distinguish patients with ischemia from those with normal perfusion as determined by thallium imaging.",

author = "Staffan Ahnve and Marios Savvides and Sleiman Abouantoun and Atwood, {J. Edwin} and Victor Froelicher",

note = "Funding Information: From the Cardiology nia, San Diego. Supported by Specialized Center of Research (SCOR), National of Health Research Grant HL 17682 awarded by the National and Blood Institute; and by International Research Fellowship 03308-01, Fogarty International Center (Dr. Ahnve). for publication July 3, 1985; revision received Oct. 1, 1985. Reprint requests: Victor F. Froelicher, M.D., Cardiology Section VA Medical Center, 5901 E. 7th St., Long Beach, CA 90822.",

year = "1986",

month = may,

doi = "10.1016/0002-8703(86)90641-1",

language = "English",

volume = "111",

pages = "909--916",

journal = "American Heart Journal",

issn = "0002-8703",