A comparison of methods of analysing exercise tests for diagnosis of coronary artery disease
The diagnostic accuracy of the following methods of analysing exercise tests were evaluated: (a) the cumulative area of ST segment depression during exercise normalised for workload and heart rate (exercise score); (b) discriminant analysis of electrocardiographic exercise variables, workload, and symptoms; and (c) ST segment amplitude changes during exercise adjusted for heart rate. Three hundred and forty five men without a history of myocardial infarction were studied. One hundred and twenty three were apparently healthy. Less than half (170) had coronary artery disease. All had a normal electrocardiogram at rest. A Frank lead electrocardiogram was computer processed during symptom limited bicycle ergometry. The accuracy of the exercise score (a) was low (sensitivity 67%, specificity 90%). Discriminant analysis (b) and ST segment amplitude changes adjusted for heart rate (c) had excellent diagnostic characteristics (sensitivity 80%, specificity 90%), which were little affected by concomitant use of beta blockers. Both methods seem well suited for diagnostic application in clinical practice.
|Keywords||*Electrocardiography, *Exercise Test, Adult, Aged, Comparative Study, Coronary Disease/*diagnosis, Discriminant Analysis, Heart Rate, Human, Male, Methods, Middle Aged, Sensitivity and Specificity|
Deckers, J.W., Rensing, B.J.W.M., Tijssen, J.G.P., Vinke, R.V.H., Azar, A.J., & Simoons, M.L.. (1989). A comparison of methods of analysing exercise tests for diagnosis of coronary artery disease. British Heart Journal, 62(6), 438–444. Retrieved from http://hdl.handle.net/1765/5403