Exercise electrocardiography detection of coronary artery disease by ST-segment depression/heart rate hysteresis in women: The Finnish Cardiovascular Study
| Autor: | Terho Lehtimäki, Jari Viik, Kari Niemelä, Mika Kähönen, Mari Niemi, Kati Svart, Tiit Kööbi, Tuomo Nieminen, Kjell Nikus, Väinö Turjanmaa, Rami Lehtinen |
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| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
Physical exercise Coronary Artery Disease Sensitivity and Specificity Cohort Studies Coronary artery disease Electrocardiography Risk Factors Internal medicine Heart rate medicine Humans ST segment Diagnosis Computer-Assisted Finland Depression (differential diagnoses) Aged ST depression Receiver operating characteristic medicine.diagnostic_test business.industry Reproducibility of Results Middle Aged Prognosis medicine.disease Surgery ROC Curve Exercise Test Cardiology Women's Health Female medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | International Journal of Cardiology. 140:182-188 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2008.11.038 |
| Popis: | Introduction The performance of exercise electrocardiography (ECG) for the detection of coronary artery disease (CAD) in women has been limited. The recently developed computerized variable, ST-segment depression/heart rate (ST/HR) hysteresis, has been proved to detect CAD in men more accurately than traditional methods. However, the diagnostic performance of ST/HR hysteresis has not been evaluated in women. Materials and methods The study population comprised 161 female patients from the Finnish Cardiovascular Study (FINCAVAS). All patients were referred for a routine bicycle exercise test. The maximum values of ST/HR hysteresis, ST/HR index, ST-segment depression at peak exercise (STpeak), at the end of one (ST1rec) and three (ST3rec) minutes of post-exercise were determined. Significant CAD was present in 48, while 65 women showed no angiographic CAD. Also a group of 48 women with low likelihood of CAD (LLC) was formed. Diagnostic performance of variables was assessed by receiver operating characteristic (ROC) analysis. Furthermore, sensitivity values at 80% specificity and specificities at 80% sensitivity were determined. Results In a comparison between CAD and LLC groups, the ROC areas for ST/HR hysteresis, ST/HR index, STpeak, ST1rec and ST3rec were 0.89, 0.74, 0.65, 0.84 and 0.73, and sensitivities at 80% specificity were 88%, 67%, 52%, 75% and 60%, respectively. Comparing CAD and no-CAD groups, the ROC areas were 0.73, 0.67, 0.56, 0.63 and 0.60, and specificities at 80% sensitivity were 60%, 38%, 27%, 33% and 30%. Conclusions ST/HR hysteresis is a more competent method in CAD detection in women than ST-segment depression or ST/HR index. |
| Databáze: | OpenAIRE |
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