Electrocardiographic score: application in exercise test for the assessment of ischemic preconditioning

the time for 1.0 mm ST-segment depression (T-1.0mm) adopted to characterize ischemic preconditioning (IPC) in sequential exercise tests is consistent and reproducible; however, it has several limitations. to apply an electrocardiographic score of myocardial ischemia in sequential exercise tests, com...

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Bibliographic Details
Published in:Arquivos brasileiros de cardiologia 2010-10, Vol.95 (4), p.486-492
Main Authors: Uchida, Augusto, Moffa, Paulo, Hueb, Whady, Cesar, Luiz Antonio Machado, Ferreira, Beatriz Moreira Ayub, Ramires, Jose Antonio Franchini
Format: Article
Language:English
Subjects:
Carbamates
Diabetes Mellitus - drug therapy
Diabetes Mellitus - physiopathology
Double-Blind Method
Electrocardiography - methods
Electrocardiography - standards
Ergometry
Female
Humans
Hypoglycemic Agents - therapeutic use
Ischemic Preconditioning
Male
Middle Aged
Myocardial Ischemia - diagnosis
Observer Variation
Piperidines
Predictive Value of Tests
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Summary:the time for 1.0 mm ST-segment depression (T-1.0mm) adopted to characterize ischemic preconditioning (IPC) in sequential exercise tests is consistent and reproducible; however, it has several limitations. to apply an electrocardiographic score of myocardial ischemia in sequential exercise tests, comparing it to the conventional T-1.0 mm index. sixty one patients with mean age of 62.2 ± 7.5 years were evaluated; 86.9% were males. A total of 151 tests were analyzed, 116 of which were from patients who completed two assessment phases. The first phase comprised two sequential exercise tests for the documentation of IPC; the second phase, initiated one week later, comprised two more tests carried out under the effect of repaglinide. Two observers who were blind to the tests applied the score. Perfect inter and intraobserver agreement was found (Kendall tau-b = 0.96, p < 0.0001, and Kendall tau-b = 0.98, p < 0.0001, respectively). Values of sensitivity and specificity, negative predictive value, positive predictive value and accuracy were 72.41%, 89.29%, 75.8%, 87.5% and 81.0%, respectively. the ischemic score is a consistent and reproducible method for the documentation of IPC, and is a feasible alternative to T-1.0 mm.
ISSN:1678-4170
DOI:10.1590/s0066-782x2010005000122