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September 1, 1991Circulation

A lesson from the controversy about heart rate adjustment of ST segment depression.

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Why the study?

Does heart rate adjustment of ST segment depression improve diagnostic accuracy for three-vessel or left main coronary disease?

Population

Patients evaluated for diseased coronary vessels (three-vessel or left main disease)

Design

Review

Key result

Heart rate adjustment of ST segment depression improved diagnostic accuracy for severe coronary disease in 8 centers but failed to improve accuracy in 7 centers, with reasons for variation unclear.

Authors

MBMarco BobbioRDRobert Detrano

Discussion

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Overview

Variability across centers cautions against routine clinical adoption of heart rate-adjusted ST depression; leaves open its diagnostic value for severe CAD.

Structured PICO

Does heart rate adjustment of ST segment depression improve diagnostic accuracy for three-vessel or left main coronary disease?

P
Population
Patients evaluated for diseased coronary vessels (three-vessel or left main disease)
I
Intervention
Heart rate adjustment of ST segment depression
O
Outcome
Diagnostic accuracy for three-vessel or left main diseasesurrogate

The diagnostic value of heart rate-adjusted ST segment depression remains controversial due to unexplained variability in performance across different centers.

Cite This Study

Bobbio et al. (1991) conducted a review in Coronary artery disease. Heart rate adjustment of ST segment depression was evaluated on Diagnostic accuracy of three-vessel or left main disease. Heart rate adjustment of ST segment depression improved diagnostic accuracy for severe coronary disease in 8 centers but failed to improve accuracy in 7 centers, with reasons for variation unclear.

synapsesocial.com/papers/6a0ff5a44fb650da4ffebd34https://doi.org/10.1161/01.cir.84.3.1410
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prognostic value of heart rate adjustment of exercise-induced ST segment depression in the multiple risk factor intervention trial1996 · 61 citations
  2. 2Heart rate adjustment of ST segment depression for improved detection of coronary artery disease.1989 · 175 citations
  3. 3Rehabilitation of the Exercise Electrocardiogram1998 · 6 citations
  4. 4Improvement in identification of multivessel disease after acute myocardial infarction following stress-recovery analysis of ST depression in the heart rate domain during exercise1994 · 22 citations
  5. 5Exercise heart rate/ST segment relation in coronary artery disease.1984 · 4 citations