Henry S Loeb1, Nicholas C Friedman. 1. Department of Cardiology, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois 60141, USA. HSL4134@yahoo.com
Abstract
OBJECTIVE: To determine if T-wave normalization during exercise or dobutamine stress testing identified patients with myocardial ischemia as indicated by reversible perfusion defects. METHODS: Exercise or dobutamine stress tests with perfusion scintigraphy were performed in 1,173 patients with abnormal T-waves on their baseline electrocardiograms. The results of perfusion scintigraphy were compared in patients with and without stress-induced T-wave normalization. RESULTS: Only 33 of 270 patients with reversible perfusion defects (12.2%) had T-wave normalization during stress while 76.4% of 140 patients who had T-wave normalization during stress did not have a reversible perfusion defect. Results were similar for patients who did or did not reach 85% of their maximal predicted heart rate, for patients with and without Q-wave infarction on the baseline EKG and for patients who did or did not have ischemic ST-segment depression during stress. CONCLUSIONS: T-wave normalization during stress testing has low sensitivity and poor positive predictive value for stress-induced reversible myocardial ischemia. (c) 2007 Wiley Periodicals, Inc.
OBJECTIVE: To determine if T-wave normalization during exercise or dobutamine stress testing identified patients with myocardial ischemia as indicated by reversible perfusion defects. METHODS: Exercise or dobutamine stress tests with perfusion scintigraphy were performed in 1,173 patients with abnormal T-waves on their baseline electrocardiograms. The results of perfusion scintigraphy were compared in patients with and without stress-induced T-wave normalization. RESULTS: Only 33 of 270 patients with reversible perfusion defects (12.2%) had T-wave normalization during stress while 76.4% of 140 patients who had T-wave normalization during stress did not have a reversible perfusion defect. Results were similar for patients who did or did not reach 85% of their maximal predicted heart rate, for patients with and without Q-wave infarction on the baseline EKG and for patients who did or did not have ischemic ST-segment depression during stress. CONCLUSIONS: T-wave normalization during stress testing has low sensitivity and poor positive predictive value for stress-induced reversible myocardial ischemia. (c) 2007 Wiley Periodicals, Inc.
Authors: Raymond J Gibbons; Gary J Balady; J Timothy Bricker; Bernard R Chaitman; Gerald F Fletcher; Victor F Froelicher; Daniel B Mark; Ben D McCallister; Aryan N Mooss; Michael G O'Reilly; William L Winters; Raymond J Gibbons; Elliott M Antman; Joseph S Alpert; David P Faxon; Valentin Fuster; Gabriel Gregoratos; Loren F Hiratzka; Alice K Jacobs; Richard O Russell; Sidney C Smith Journal: J Am Coll Cardiol Date: 2002-10-16 Impact factor: 24.094
Authors: Kyung Jin Kim; Wan Joo Shim; Seong Won Jung; Hui Nam Pak; Soo Jin Lee; Woo Hyuk Song; Young Hoon Kim; Hong Seog Seo; Dong Joo Oh; Young Moo Ro Journal: Korean J Intern Med Date: 2002-06 Impact factor: 2.884