A new criterion combining ST/HR slope and ΔST/ΔHR index for detection of coronary artery disease in patients on digoxin therapy

被引:10
作者
Hamasaki, S [1 ]
Nakano, F [1 ]
Arima, S [1 ]
Tahara, M [1 ]
Kamekou, M [1 ]
Fukumoto, N [1 ]
Yamaguchi, T [1 ]
Kihara, K [1 ]
Shono, H [1 ]
Nakao, S [1 ]
Tanaka, H [1 ]
机构
[1] Kagoshima Univ, Fac Med, Dept Internal Med 1, Kagoshima 890, Japan
关键词
D O I
10.1016/S0002-9149(98)00124-6
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We evaluated the clinical value of a new index combining Delta ST/Delta heart rate (HR) index and ST/HR slope for diagnosing coronary artery disease (CAD) in patients on digoxin therapy. Exercise treadmill tests were performed by 72 patients on digoxin therapy. Simple HR-adjusted indexes of ST-segment depression during exercise (Delta ST/Delta HR index) and the decline calculated from the final 12 data points relating ST-segment depression to HR (ST/HR slope) were determined. A new index was obtained by subtracting the Delta ST/Delta HR index from the ST/HR slope. On thallium scintigraphy, 37 of the 72 patients showed reversible perfusion defects related to the diseased coronary artery. The new index derived from this ST-HR relation was 4.1 +/- 3.6 mu V/beats/min in the ischemic group and 1.3 +/- 1.0 mu V/beats/min in the group of patients without ischemia (p <0.0001). An ST-HR relation greater than or equal to 1.5 was found in 33 of the 37 patients in the ischemic group, and in 7 of the 35 patients without ischemia (p <0.0001). The sensitivity of this criterion for prediction of myocardial ischemia was 89%, the specificity was 80%, and the predictive accuracy was 85%. Thus, this new ST-HR index is useful for detecting CAD in patients on digoxin therapy. (C) 1998 by Excerpta Medica, Inc.
引用
收藏
页码:1100 / 1104
页数:5
相关论文
共 27 条
[1]   GRADED EXERCISE STRESS TESTS IN ANGIOGRAPHICALLY DOCUMENTED CORONARY-ARTERY DISEASE [J].
BARTEL, AG ;
BEHAR, VS ;
PETER, RH ;
ORGAIN, ES ;
KONG, Y .
CIRCULATION, 1974, 49 (02) :348-356
[2]   MULTIVARIATE APPROACH FOR INTERPRETING TREADMILL EXERCISE TESTS IN CORONARY-ARTERY DISEASE [J].
BERMAN, JL ;
WYNNE, J ;
COHN, PF .
CIRCULATION, 1978, 58 (03) :505-512
[3]   WHAT ELECTROCARDIOGRAPHIC LEADS TO TAKE AFTER EXERCISE [J].
BLACKBURN, H ;
KATIGBAK, R .
AMERICAN HEART JOURNAL, 1964, 67 (02) :184-&
[4]  
DEPUEY EG, 1988, J NUCL MED, V29, P1479
[5]   EXERCISE ELECTROCARDIOGRAPHIC VARIABLES - A CRITICAL-APPRAISAL [J].
DETRANO, R ;
SALCEDO, E ;
PASSALACQUA, M ;
FRIIS, R .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1986, 8 (04) :836-847
[6]   THE ST SEGMENT HEART-RATE SLOPE AS A PREDICTOR OF CORONARY-ARTERY DISEASE - COMPARISON WITH QUANTITATIVE THALLIUM IMAGING AND CONVENTIONAL ST SEGMENT CRITERIA [J].
FINKELHOR, RS ;
NEWHOUSE, KE ;
VROBEL, TR ;
MIRON, SD ;
BAHLER, RC .
AMERICAN HEART JOURNAL, 1986, 112 (02) :296-304
[7]   CORONARY-ARTERY VASOCONSTRICTION ROUTINELY OCCURS AFTER PERCUTANEOUS TRANS-LUMINAL CORONARY ANGIOPLASTY - A QUANTITATIVE ARTERIOGRAPHIC ANALYSIS [J].
FISCHELL, TA ;
DERBY, G ;
TSE, TM ;
STADIUS, ML .
CIRCULATION, 1988, 78 (06) :1323-1334
[8]   TREADMILL STRESS TESTS AS INDICATORS OF PRESENCE AND SEVERITY OF CORONARY-ARTERY DISEASE [J].
GOLDSCHLAGER, N ;
SELZER, A ;
COHN, K .
ANNALS OF INTERNAL MEDICINE, 1976, 85 (03) :277-286
[9]   A new predictor of restenosis after successful percutaneous transluminal coronary angioplasty in patients with multivessel coronary artery disease [J].
Hamasaki, S ;
Abematsu, H ;
Arima, S ;
Tahara, M ;
Kihara, K ;
Shono, H ;
Nakao, S ;
Tanaka, H .
AMERICAN JOURNAL OF CARDIOLOGY, 1997, 80 (04) :411-415
[10]   Increase in Delta ST/Delta heart rate (HR) index: A new predictor of restenosis After successful percutaneous transluminal coronary angioplasty [J].
Hamasaki, S ;
Arima, S ;
Tahara, M ;
Kihara, K ;
Shono, H ;
Nakao, S ;
Tanaka, H .
AMERICAN JOURNAL OF CARDIOLOGY, 1996, 78 (09) :990-995