Key result
More leads with exercise ST depression linked to ~3-fold CAD severity, but cannot localize lesions.
Why the study?
The relationship between the body surface distribution of exercise-induced ST depression and the severity or location of coronary artery disease in angina patients was unclear.
Does the body surface distribution of exercise-induced ST depression correlate with the severity and location of coronary artery disease in patients with angina pectoris?
Cross-Sectional (n=38)
No
Does the body surface distribution of exercise-induced ST depression correlate with the severity and location of coronary artery disease in patients with angina pectoris?
Absolute Event Rate: 23.6% vs 7.2%
p-value: p=<0.001
The extent of exercise-induced ST depression across 87 body surface leads correlates with the severity of coronary artery disease but cannot localize the specific obstructed vessel.
ST depression extent across leads may gauge CAD severity in angina; leaves open localization utility and needs prospective validation.
In 38 patients with angina pectoris, 87 unipolar lead electrocardiograms were recorded from different sites over the entire thoracic surface both before and after submaximal treadmill exercise. The site of exercise-induced ST depression on the body surface was correlated with the findings of the coronary arteriography. The number of leads which showed exercise-induced ST depression was 7.2 +/- 1.8 in one vessel disease, 15.6 +/- 2.1 in two vessel disease, and 23.6 +/- 2.0 in three vessel disease (values are mean +/- SEM). Thus, the number of leads showing ST depression was proportional to the severity of the coronary artery disease. Exercise-induced ST depression was most often seen in left anterior chest leads, especially in V5 of the standard 12-ECG. However, it was not possible to identify the obstructed coronary artery from the body surface distribution of ST depression.
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Kubota et al. (1983) conducted a cross-sectional in Angina pectoris (n=38). Severity of coronary artery disease (number of diseased vessels) vs. One vessel disease was evaluated on Number of leads showing exercise-induced ST depression (p=<0.001). The number of leads showing exercise-induced ST depression was proportional to the severity of coronary artery disease (23.6 in 3-vessel vs 7.2 in 1-vessel disease), but could not identify the specific obstructed artery.
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