Comparison of the ST/heart rate slope with the modified Bruce exercise test in the detection of coronary artery disease |
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| Authors: | B C Thwaites A A Quyyumi M J Raphael R Canepa-Anson K M Fox |
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| Affiliation: | 1. Department of Public Health and Primary Care, Ghent University, Ghent, Belgium;2. Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium;3. Ghent University Hospital, Ghent, Belgium;4. National Heart & Lung Institute, Imperial College London, London, UK;5. National Institute for Prevention and Cardiovascular Health, National University of Ireland, Galway, Ireland;6. Imperial College Healthcare NHS Trust, London, UK;1. Pediatric and Adult Congenital Heart Disease Center, IRCCS Policlinico San Donato University Hospital, San Donato Milanese (MI), Italy;2. Exercise Pathophysiology Laboratory, Cardiac Rehabilitation Division, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Veruno, Veruno (NO), Italy;3. Bioengineering Service, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Veruno, Veruno (NO), Italy;1. Department of Cellular & Integrative Physiology, Indiana University School of Medicine, Indianapolis, IN 46202-5120, United States;2. RTI International, Global Health Technologies, Research Triangle Park, NC 27709, United States |
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| Abstract: | The rate of depression of the ST segment with increasing heart rate (HR) during exercise has been claimed to predict the extent of coronary artery disease (CAD). To determine whether the maximal ST/HR slope is better than the Bruce treadmill exercise test for predicting the presence of CAD, the maximal ST segment/HR slope was calculated in 81 patients and compared with the results of a standard 12-lead exercise test. In 21 patients (26%), the ST/HR slope could not be calculated. In 60 patients with ST/HR slope values, the extent of CAD was predicted in 24 patients (40%). The sensitivity and specificity of the ST/HR slope in predicting the presence of CAD in the 60 patients with slope values were 91% and 27%, respectively. The sensitivity and specificity of the modified Bruce treadmill exercise test in the 81 patients were 81% and 64%, respectively. Thus, the use of the ST/HR slope does not provide additional information that cannot be obtained using the standard Bruce exercise test. |
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