AI Article Synopsis
- The study examines the effectiveness of specific electrocardiographic (ECG) markers during exercise in detecting significant stenosis of the left anterior descending (LAD) artery in patients with single or multivessel coronary artery disease (CAD).
- Within a sample of 196 patients, those exhibiting all three markers (ST elevation in V1 and aVR, plus ST depression in V5) had high rates of significant LAD stenosis, especially in single-vessel disease (93%).
- The findings suggest that these ECG changes could serve as reliable indicators for diagnosing LAD stenosis during exercise testing.
Article Abstract
Background: It is known that exercise-induced ST-segment elevation in lead V1 (V1-E) detects left anterior descending (LAD) stenosis. It was also postulated that ST elevation in aVR and simultaneous ST depression in V5 (aVR-E + V5-D) is a marker of ischemia due to significant stenosis of the LAD in patients with single-vessel disease.
Hypothesis: This study was undertaken to investigate the significance of the concomitant appearance of both electrocardiographic (ECG) ischemic markers, and of each of them alone during exercise, to detect either LAD stenosis as single-vessel coronary artery disease (CAD), or multivessel CAD involving LAD stenosis.
Methods: A total of 196 consecutive patients (152 men and 44 women, mean age 54 +/- 7 years) with at least one of these ECG markers, who underwent treadmill exercise testing with the Bruce protocol and coronary arteriography, were studied.
Results: Patients were divided into three groups. In Group A (83 patients with V1-E + aVR-E & V5-D), 93% of patients with single-vessel disease had significant LAD stenosis (p<0.001), whereas 75% of patients with double-vessel disease had significant stenoses of the LAD and the left circumflex (LCx) coronary arteries (p<0.01). In Group B (97 patients with aVR-E & V5-D but without V1-E), 43% of patients with single-vessel disease had significant LAD stenosis (p<0.08), whereas 85% of patients with double-vessel disease had significant stenoses of the LAD and the right coronary artery (RCA) (p<0.01). In Group C (16 patients with only V1-E), 60% of patients with single-vessel disease had significant LAD stenosis (p<0.05), whereas 75% of patients with double-vessel disease had significant LAD and LCx stenoses (p<0.05).
Conclusions: The concomitant appearance of exercise-induced ST elevation in lead V1, ST elevation in lead aVR, and ST depression in lead V5, as well as the isolated appearance of ST elevation in lead V1 detect significant LAD stenosis as single-vessel disease, or significant stenoses of LAD and LCx arteries in patients with double-vessel disease, whereas the appearance of ST elevation in aVR & ST depression in V5 but without ST elevation in V1 correlates strongly with significant LAD and RCA stenoses and usually indicates double-vessel disease.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6654754 | PMC |
| http://dx.doi.org/10.1002/clc.4960260506 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Left Atrial Enlargement in Primary Cryptogenic Strokes Without Atrial Fibrillation.
Cureus
December 2024
Cardiovascular Disease, HCA Houston Healthcare, Kingwood, USA.
The relationship between left atrial enlargement (LAE) and primary cryptogenic stroke (PCS) remains a mystery. LAE has been proposed to be an independent risk factor of PCS, recurrent ischemic strokes, paroxysmal atrial fibrillation, and thromboembolism. Our study evaluates the prevalence of LAE among patients with PCS in the absence of atrial fibrillation, unlike previous studies that included atrial fibrillation, in order to isolate LAE as a risk factor.
View Article and Find Full Text PDFA New Semi-Quantitative Parameter to Assess Functionally Significant Coronary Disease Using Myocardial Contrast Echocardiography.
Rev Cardiovasc Med
December 2024
Department of Echocardiography, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100006 Beijing, China.
Background: Quantitative flow ratio (QFR) can identify functionally significant coronary disease non-invasively. Myocardial contrast echocardiography (MCE) is a non-invasive and effective procedure for detecting abnormalities in hemodynamic coronary artery stenosis. Currently, there is no research confirming the correlation between MCE and QFR.
View Article and Find Full Text PDFChest Pain at Rest With Unremarkable ECG and Cardiac Enzymes: Case Study Emphasising the Importance of Clinical Suspicion in the Diagnosis of Coronary Artery Disease.
In Vivo
December 2024
Department of Health and Care Professions, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K.;
Background: Coronary artery disease (CAD), primarily caused by atherosclerosis, is a leading cause of death, presenting as angina or myocardial infarction. Advances in cardiac imaging, angiography, and procedures like percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery have improved early detection and management of this condition. This report presents the case of a man who experienced worsening exertional chest pain and discomfort while at rest.
View Article and Find Full Text PDFDiaphragmatic Nerve Paralysis After Redo Aortic Valve Replacement That Improved Over Time and Led to Successful Ventilator Weaning: A Case Report.
Cureus
November 2024
Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN.
We report a 75-year-old female with a history of two heart operations: aortic valve replacement (St. Jude Medical 21 mm) at the age of 44 years for severe rheumatic aortic stenosis and mitral valve replacement (Carbomedics 29 mm) at the age of 51 years for rheumatic mitral regurgitation. Decades later, she presented with exertional dyspnea.
View Article and Find Full Text PDFSevere restenosis after stentless treatment with coronary intravascular lithotripsy for calcified nodule lesions: a serial observation with IVUS.
Oxf Med Case Reports
December 2024
Department of Cardiology, Pulmonology, Hypertension & Nephrolgy, Ehime University Graduate School of Medicine, Toon, Japan.
An 82-year-old woman with a history of myocardial infarction presented with worsening effort angina. Coronary angiography (CAG) revealed 75% stenosis in the proximal left anterior descending artery (LAD), with intravascular ultrasound (IVUS) identifying a severe calcified nodule near a previously implanted drug-eluting stent. The lesion was treated with intravascular lithotripsy (IVL) and a drug-coated balloon (DCB), avoiding left main crossover stenting.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!