ArticleClinical cardiology2017
Exercise test predictors of severe coronary artery disease: Role of ST-segment elevation in lead aVR.
Article in Clinical cardiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 7 citations in OpenAlex.
- Predictive value of the electrocardiogram exercise stress test for the presence or absence of left main disease.Frontiers in cardiovascular medicine · 2025Article
- Identifying Ventricular Dysfunction Indicators in Electrocardiograms via Artificial Intelligence-Driven Analysis.Bioengineering (Basel, Switzerland) · 2024Article
- Abnormal vasodilator stress electrocardiogram with normal myocardial perfusion: Clinical decision-making and review of literature.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Review
- Exercise test predictors of severe coronary artery disease: Role of ST-segment elevation in lead aVR.Clinical cardiology · 2017Article
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7 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe role of exercise stress test (EST)-induced ST-segment elevation (STE) in electrocardiographic lead aVR in predicting severe coronary artery disease (CAD) is controversial. HYPOTHESIS: Assessment of lead aVR during EST can be helpful to identify patients with severe CAD.
methodsWe performed maximal EST in 200 patients undergoing coronary angiography for suspect of CAD. Four angiographic findings of severe CAD were considered: (1) left main (LM) disease; (2) LM or equivalent LM (LM/EQLM) disease; (3) LM or proximal left anterior descending (LAD) artery (LM/proxLAD) disease; and (4) LM or 3-vessel (LM/3V) disease.
resultsLM, LM/EQLM, LM/proxLAD, and LM/3V disease were shown in 6 (3%), 13 (6.5%), 33 (16.5%), and 27 (13.5%) patients, respectively. EST-induced STE in aVR occurred in 41 patients (20.5%). ST-segment depression (STD) in ≥5 leads was the only predictor of LM stenosis (odds ratio [OR]: 6.18, 95% confidence interval [CI]: 1.19-32.2, P = 0.03) and the most significant variable associated with LM/proxLAD stenosis (OR: 4.73, 95% CI: 2.0-11.2, P = 0.0001); maximal STD ≥3 mm was the most significant variable associated with LM/EQLM (OR: 7.58, 95% CI: 2.31-24.9, P = 0.001) and LM/3V (OR: 3.86, 95% CI: 1.47-10.1, P = 0.006) CAD. EST-induced STE in aVR was associated with LM/proxLAD disease only (OR: 3.23, 95% CI: 1.44-7.24, P = 0.004). At multivariate analysis, STD in ≥5 leads was the only independent predictor of LM/proxLAD disease (OR: 3.99, 95% CI: 1.58-10.1, P = 0.003).
conclusionsEST-induced STE in lead aVR does not significantly increase the prediction of severe CAD compared with severity and extension of STD as assessed in the other electrocardiographic leads.
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