BACKGROUND: This study investigated the value of exercise-induced ST-segment elevation in lead aVR with or without concomitant ST-segment elevation in lead V(1) for detection of left main (LM) coronary artery disease in patients with Duke treadmill score <or=-11. METHODS: One hundred and four patients with Duke treadmill score <or=-11 were retrospectively screened for presence of ST-segment elevation in lead aVR and lead V(1). RESULTS: Twenty-six out of 65 patients with ST-segment elevation in lead aVR and 24 out 38 patients with ST-segment elevation in lead aVR with concomitant ST-segment elevation in lead V(1) were found to have LM disease. Exercise-induced ST-segment elevation in lead aVR had a sensitivity of 92.9% and a specificity of 48.6% and ST-segment elevation in lead aVR accompanied by ST-segment elevation in lead V(1) had a sensitivity of 85.7% and a specificity of 81.6% in predicting LM disease. CONCLUSIONS: This study shows that the observation of exercise-induced ST-segment elevation in lead aVR is a sensitive, but not a specific, electrocardiographic finding of significant LM coronary artery disease. However, exercise-induced ST-segment elevation in lead aVR accompanied by ST-segment elevation in lead V(1) might be not only a sensitive but also a specific finding of LM stenosis in these patients.
BACKGROUND: This study investigated the value of exercise-induced ST-segment elevation in lead aVR with or without concomitant ST-segment elevation in lead V(1) for detection of left main (LM) coronary artery disease in patients with Duke treadmill score <or=-11. METHODS: One hundred and four patients with Duke treadmill score <or=-11 were retrospectively screened for presence of ST-segment elevation in lead aVR and lead V(1). RESULTS: Twenty-six out of 65 patients with ST-segment elevation in lead aVR and 24 out 38 patients with ST-segment elevation in lead aVR with concomitant ST-segment elevation in lead V(1) were found to have LM disease. Exercise-induced ST-segment elevation in lead aVR had a sensitivity of 92.9% and a specificity of 48.6% and ST-segment elevation in lead aVR accompanied by ST-segment elevation in lead V(1) had a sensitivity of 85.7% and a specificity of 81.6% in predicting LM disease. CONCLUSIONS: This study shows that the observation of exercise-induced ST-segment elevation in lead aVR is a sensitive, but not a specific, electrocardiographic finding of significant LM coronary artery disease. However, exercise-induced ST-segment elevation in lead aVR accompanied by ST-segment elevation in lead V(1) might be not only a sensitive but also a specific finding of LM stenosis in these patients.
Authors: Dmitriy Kireyev; Mikhail V Arkhipov; Stephen T Zador; Joseph A Paris; William E Boden Journal: Ann Noninvasive Electrocardiol Date: 2010-04 Impact factor: 1.468
Authors: James McKinney; Ian Pitcher; Christopher B Fordyce; Masoud Yousefi; Tee Joo Yeo; Andrew Ignaszewski; Saul Isserow; Sammy Chan; Krishnan Ramanathan; Carolyn M Taylor Journal: PLoS One Date: 2016-07-28 Impact factor: 3.240