Different partition criterion for leads i and -aVR in detection of the coronary artery disease by exercise electrocardiography

J. Viik, R. Lehtinen, V. Turjanmaa, K. Niemelä, J. Malmivuo

    Research output: Other conference contributionPosterScientific

    Abstract

    Purpose: The objective of this study was to compare the diagnostic capabilities of the end-exercise ST-segment depression (STend) of individual exercise electrocardiographic (ECG) lends in the discrimination of coronary artery disease (CAD) patients and clinically normal patients. Methods: The study population consisted of 201 male patients. 101 with CAD and 100 reference. The CAD group (mean age 54±8, HR 126±H) did not include any patients with left or right bundle branch block or recent myocardial infarction. The reference group (46±13, 164±19) comprised clinically normal patients. The diagnostic capabilities of individual leads were compared using receiver operating characteristic (ROC) curve analysis. Statistical comparison of the leads was made by a univariate Z score test with lead V5. The sensitivity values at 95% specificity were also defined and compared with lead V5 by means of McNemar's test. Results: Areas under the ROC-curvcs in every lead are presented in the table (percentages of total ROC-space). The sensitivities at 95% specificity and corresponding partition values of STend (ST depressions as negative values) are also shown in the table. aVL I -aVR II aVF III V1 V2 V3 V4 V5 V6 ROC-area[%] 58.1* 89.3 87.3 81.6 75.1* 66.4* 43.7* 71.8* 82.1* 85.4* 86.8 86.9 Sensitivity[%] 5.0* 59.4 54.5 35.6* 28.7* 15.8* 0.0* 22.8* 28.7* 54.5 59.4 62.4 Partition value[mV] -0.06 -0.02 -0.03 -0.06 -0.07 -0.08 -0.10 0.01 0.02 -0.02 -0.06 -0.06 * p<0.01 compared with V5 Conclusions: According to results, the use of leads I, -aVR. V4, V5 and V6 is the most powerful in the analysis of the end-exercise ST-seginent depression. The results shows distinctly that leads aVL. VI and HI should be excluded from the analysis. The partition value applied for leads I and -aVR should be half than used for lateral precordial leads.

    Original languageEnglish
    Publication statusPublished - 1997
    Publication typeNot Eligible
    EventXVI Nordic Congress of Cardiology, Tampere, Finland, June 11-13, 1997. Scandinavian Cardiovascular Journal -
    Duration: 1 Jan 1997 → …

    Conference

    ConferenceXVI Nordic Congress of Cardiology, Tampere, Finland, June 11-13, 1997. Scandinavian Cardiovascular Journal
    Period1/01/97 → …

    ASJC Scopus subject areas

    • General Medicine

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