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European Heart Journal 1983 4(9):614-621;
Copyright © 1983 by the European Society of Cardiology.
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© 1983, by the European Society of Cardiology

Useless diagnostic value of exercise-induced R wave changes in coronary artery disease

M. ALIJARDE-GUIMERÁ, A. EVANGELISTA, E. GALVE, S. OLIVÉ, I. ANIVARRO and J. SOLER-SOLER

Servicio de Cardiologia, Departamento de Medicina Interna, Ciudad Sanitaria de la Seguridad Social Barcelona, Spain

Received 8 September 1982; revised 24 November 1982; .

Address for reprints: M. Alijarde-Guimerá, Servicio de Cardio-logia, Ciudad Sanitaria Seguridad Social. Paseo Valle de Hebron s/n, Barcelona 35, Spain.

Abstract

To investigate the usefulness of exercise-induced R wave changes in the diagnosis of coronary artery disease and detection of left ventricular contraction abnormalities, 105 patients were studied. Among 64 patients who had significant coronary artery disease (≥ 70% narrowing), 43 showed an increase or no change in the R wave amplitude and 55 showed ST segment depression (sensitivity 67 versus 86%). Among 41 patients without significant stenosis, 11 had decreased R wave amplitude and 36 had no change in ST segment (specificity 27 versus 88%). Twenty-five of 64 coronary disease patients had left ventricular contraction abnormalities, and the R wave amplitude changes gave a sensitivity of 80%, specificity of 41% and a predictive value of 47%. There were no differences in the variables of exercise intensity and ejection fraction between patients who had decreased R wave amplitude and those in whom it increased or did not change.

We conclude that R wave amplitude change during exercise is not a useful variable for the diagnosis or evaluation of patients with coronary artery disease.

Key Words: R wave amplitude • stress testing • coronary artery disease • left ventricular dysfunction


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