Factors influencing R wave amplitude in patients with ischaemic heart disease.
Key result
Precordial R wave amplitude changes during ischemia fail to track LV volume, lacking diagnostic value.
- n=10
Why the study?
Do precordial R wave changes during exercise correlate with alterations in left ventricular volume or respiratory pattern in patients with coronary disease?
Population
10 patients with angina and coronary disease
Design
Cohort
Authors
Discussion
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Implication
Clinicians should not rely on precordial R wave changes to diagnose ischaemia on exercise ECG; cohort data leaves open whether alternative markers improve diagnostic accuracy.
Study Design
Type
Observational (n=10)
Structured PICO
Do precordial R wave changes during exercise correlate with alterations in left ventricular volume or respiratory pattern in patients with coronary disease?
P
Population
10 patients with angina and coronary disease undergoing exercise tests and manoeuvres to provoke ischaemia.
E
Exposure
Three identical exercise tests with 16 lead precordial map and continuous left ventricular volume assessment using gated blood pool imaging
O
Outcome
Reproducibility of exercise QRS changes and their relation to ST segment depression, respiratory pattern, and left ventricular volume during ischaemiasurrogate
R wave amplitude changes during exercise have little diagnostic value for ischaemia as they are not primarily determined by alterations in left ventricular volume or respiratory pattern.
Cite This Study
Deanfield et al. (1983) conducted an observational in Angina and coronary disease (n=10). Exercise tests and manoeuvres to provoke ischaemia was evaluated on R wave amplitude changes and their relation to left ventricular volume and respiratory pattern. Precordial R wave amplitude changes during ischaemia did not alter in 33 of 39 episodes of left ventricular volume changes, suggesting they have little diagnostic value.