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Determinants of Exercise-Induced ST Segment Depression in Patients with Coronary Artery Disease: A Multivariate Approach

Ioannis Kalpoyiannakis, MD

Spyros Papazoglou, MD

N.M. Papazoglou, MD, FCCP

Cardiology Department University of Athens 64 Sina Street GR-106 72 Athens, Greece

The purpose of this study was to delineate among the usually gathered parameters in an electrocardiographic exercise test the determinants of its positive outcome (ST 1 mm measured at 80 msec from the J point). The authors studied 832 patients investigated with Bruce's exercise testing and with diagnostic coronary arteriography, all of whom were shown to have significant coronary artery disease (diameter stenosis 50%). Twenty-five demographic, clinical, electrocardiographic, exercise, and anatomic/hemo dynamic parameters were analyzed. The stepwise forward logistic regression analysis retained seven among them as significant independent predictors: four as positive contributors: (1) three-vessel and/or left main disease (P=0.0000), (2) Gensini's angio graphic score for disease extent (P=0.0025), (3) anginal pain during the test (P=0.0000), and (4) age (P=0.0031) and three as negative contributors: (1) resting heart rate (P=0.0004), (2) history of old myocardial infarction (P=0.0019), and (3) pathological Q waves at the resting ECG (P=0.0018).

These findings establish standards that permit the prediction of the positive electro cardiographic exercise outcome in patients with significant coronary disease.

Angiology, Vol. 48, No. 2, 135-139 (1997)
DOI: 10.1177/000331979704800206


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