Why the study?
Does the use of multiple ECG leads increase the detection of exercise-induced ST-segment elevation and what are its angiographic correlates in patients undergoing exercise testing before coronary arteriography?
Does the use of multiple ECG leads increase the detection of exercise-induced ST-segment elevation and what are its angiographic correlates in patients undergoing exercise testing before coronary arteriography?
Exercise-induced ST-segment elevation is better detected using multiple ECG leads and strongly correlates with previous myocardial infarction, severe coronary stenosis, and regional wall motion abnormalities.
Answers are grounded in this paper and cite their sources.
Multiple-lead ECG may enhance detection of exercise-induced ST elevation; hypothesis-generating for prognostic value in coronary disease.
ST-segment elevation was observed in 47 of 720 patients who underwent treadmill exercise testing using 14 ECG leads 1 day before coronary arteriography. This abnormality was detected in lead V. in only 13 of 47 patients (28%) and in lead CM5 in only nine of 47 patients (19%). In 36 patients previous myocardial infarction (27 anterior, nine inferior) was diagnosed on the resting ECG; in all cases the ST-segment elevation during exercise occurred in leads with Q waves. In 34 of 36 patients (94%) a corresponding left ven- tricular wall motion abnormality was present, usually (33 of 36, 92%) a dyskinetic or akinetic segment. All but two of the 36 patients had a coronary stenosis > 70% in the artery perfusing the involved region.
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Waters et al. (1980) studied this question.
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