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European Heart Journal 1986 7(9):760-764;
Copyright © 1986 by the European Society of Cardiology.
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© 1986 The European Society of Cardiology

Diagnostic value of R wave amplitude changes during exercise testing after myocardial infarction

S. DE HERT, C. VRINTS, E. VANAGT and J. SNOECK

Department of Cardiology, University Hospital Antwerp, Belgium

revised 25 February 1986; accepted 23 December 1985.

Address for correspondence: S. De Hert, Department of Cardiology, University Hospital Antwerp, Wilrijkstraat 10, B-2520 Edegem, Belgium.

Abstract

To determine the diagnostic value of R wave amplitude changes occurring during exercise testing after myocardial infarction, exercise ECG's and coronary angiograms were reviewed in 76 postinfarction patients and in 40 patients with normal coronary arteries.

During exercise, an increase in R wave amplitude (mean: +2.7±13 mm) was observed in the post infarction patients, significantly different (P<0.001) from the decrease (mean: –2.6± 1.1 mm) observed in the group with normal coronary arteries. Although this change increased with the number of diseased coronary arteries, the difference between 1-vessel andmulti- or 3-vessel disease was not significant.

Extension of infarct size from one to more akinetic segments on the left ventricular angiogram was associated with a significant (P<0.001) increase of the R wave amplitude change during exercise (mean:+ l.6±l.lvs3.3+l.3mm).

It is concluded that the abnormal increase in R wave amplitude observed during exercise testing after myocardial infarction is more strongly related to infarct size then to the number of diseased coronary arteries. Furthermore exercise induced R wave amplitude changes have no diagnostic value in the prediction ofmulti- or 3-vessel disease in postinfarction patients.

Key Words: Exercise testing, • R wave amplitude changes, • myocardial infarction, • coronary artery disease, • left ventricular dysfunction.


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