RT Journal Article
SR Electronic
T1 A comparison of methods of analysing exercise tests for diagnosis of coronary artery disease.
JF British Heart Journal
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 438
OP 444
DO 10.1136/hrt.62.6.438
VO 62
IS 6
A1 J W Deckers
A1 B J Rensing
A1 J G Tijssen
A1 R V Vinke
A1 A J Azar
A1 M L Simoons
YR 1989
UL http://heart.bmj.com/content/62/6/438.abstract
AB The diagnostic accuracy of the following methods of analysing exercise tests were evaluated: (a) the cumulative area of ST segment depression during exercise normalised for workload and heart rate (exercise score); (b) discriminant analysis of electrocardiographic exercise variables, workload, and symptoms; and (c) ST segment amplitude changes during exercise adjusted for heart rate. Three hundred and forty five men without a history of myocardial infarction were studied. One hundred and twenty three were apparently healthy. Less than half (170) had coronary artery disease. All had a normal electrocardiogram at rest. A Frank lead electrocardiogram was computer processed during symptom limited bicycle ergometry. The accuracy of the exercise score (a) was low (sensitivity 67%, specificity 90%). Discriminant analysis (b) and ST segment amplitude changes adjusted for heart rate (c) had excellent diagnostic characteristics (sensitivity 80%, specificity 90%), which were little affected by concomitant use of beta blockers. Both methods seem well suited for diagnostic application in clinical practice.