Why the study?
Does ST-segment depression in hyperventilation indicate a false positive exercise test in patients with mitral valve prolapse?
Does ST-segment depression in hyperventilation indicate a false positive exercise test in patients with mitral valve prolapse?
In patients with mitral valve prolapse and a positive exercise test, ST-segment depression during hyperventilation strongly suggests a false positive result (normal coronary arteries).
ST-segment depression during hyperventilation may flag false-positive exercise tests in mitral valve prolapse; hypothesis-generating and requires prospective validation.
Objectives. Mitral valve prolapse (MVP) is a known cause for false positive exercise test (ET). The purpose of this study was to establish additional electrocardiographic criteria to distinguish the false positive exercise results in patients with MVP. Methods. We studied 218 consecutive patients (53 ± 6 years, 103 males) with MVP (according to echocardiographic study), and positive treadmill ET was performed due to multiple cardiovascular risk factors or angina-like symptoms. A coronary angiography was performed to detect coronary artery disease (CAD). Results. From 218 patients, 90 (group A) presented with normal coronary arteries according to the angiography (false positive ET) while the rest 128 (group B) presented with CAD. ST-segment depression in hyperventilation phase was present in 54 patients of group A (60%) while only in 14 patients of group B (11%), P < .05. Conclusions. Presence of ST-segment depression in hyperventilation phase favors a false positive ET in patients with MVP.
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Michaelides et al. (2010) studied this question.
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