Significance of exercise-induced simultaneous ST-segment changes in lead aVR and V5

This study was undertaken to investigate the ability of the exercise-induced ST depression in lead V5 and concomitant ST elevation in lead aVR for the identification of the significantly narrowed coronary artery in patients with single vessel disease. We studied 229 consecutive patients who develope...

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Bibliographic Details
Published in:International journal of cardiology 1999-09, Vol.71 (1), p.49-56
Main Authors: MICHAELIDES, A. P, PSOMADAKI, Z. D, RICHTER, D. J, DILAVERIS, P. E, ANDRIKOPOULOS, G. K, STEFANADIS, C, GIALAFOS, J. E, TOUTOUZAS, P. K
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Cardiac Catheterization
Cardiology. Vascular system
Coronary Angiography
Coronary Disease - diagnosis
Coronary Disease - physiopathology
Coronary heart disease
Electrocardiography - methods
Electrophysiology
Exercise Test
Female
Heart
Humans
Male
Medical sciences
Middle Aged
Thallium Radioisotopes
Tomography, Emission-Computed, Single-Photon
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Summary:This study was undertaken to investigate the ability of the exercise-induced ST depression in lead V5 and concomitant ST elevation in lead aVR for the identification of the significantly narrowed coronary artery in patients with single vessel disease. We studied 229 consecutive patients who developed the aforementioned exercise-induced electrocardiographic changes. All underwent Thallium-201 scintigraphy and coronary arteriography. Patients were divided into three groups. In group A, 58 patients with ST depression in V5 and ST elevation in aVR, in group B 149 patients with ST depression in V5 without ST elevation in aVR, and in group C 22 patients with ST elevation in aVR without ST depression in V5 induced with exercise, were included. In group A, 81% of the patients while in group B, 29% and in group C only 18% of the patients had left anterior descending artery disease. According to Thallium-201 scintigraphy, 80% of the group A, 27% of the group B and 12% of the group C patients developed myocardial ischemia in areas supplied by the left anterior descending artery. Thus, exercise-induced ST depression in V5 and concomitant ST elevation in aVR, may detect left anterior descending artery significant stenosis in patients with single vessel disease.
ISSN:0167-5273
1874-1754
DOI:10.1016/S0167-5273(99)00115-1