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Comparison between exercise ECG and coronary angiography

R Andrew Archbold
Cardiologists in the UK use clinical practice guidelines from the National Institute for Health and Care Excellence (NICE) and from the European Society of Cardiology (ESC) to aid clinical decision-making. This review compares their recommendations regarding stable angina. NICE's diagnostic algorithm changed clinical practice in the UK, with most cardiologists moving from the exercise ECG towards newer, more accurate imaging modalities such as CT and MRI for diagnostic testing in patients with a low or medium probability of coronary artery disease (CAD), and directly to invasive coronary angiography in patients with a high probability of CAD...
2016: Open Heart
Kye-Hwan Kim, Kyung Nyeo Jeon, Min Gyu Kang, Jong Hwa Ahn, Jin-Sin Koh, Yongwhi Park, Seok-Jae Hwang, Young-Hoon Jeong, Choong Hwan Kwak, Jin-Yong Hwang, Jeong Rang Park
BACKGROUND/AIMS: This study is a head-to-head comparison of predictive values for long-term cardiovascular outcomes between exercise electrocardiography (ex-ECG) and computed tomography coronary angiography (CTCA) in patients with chest pain. METHODS: Four hundred and forty-two patients (mean age, 56.1 years; men, 61.3%) who underwent both ex-ECG and CTCA for evaluation of chest pain were included. For ex-ECG parameters, the patients were classified according to negative or positive results, and Duke treadmill score (DTS)...
September 2016: Korean Journal of Internal Medicine
(no author information available yet)
UNLABELLED: In July 2009, the Medical Advisory Secretariat (MAS) began work on Non-Invasive Cardiac Imaging Technologies for the Diagnosis of Coronary Artery Disease (CAD), an evidence-based review of the literature surrounding different cardiac imaging modalities to ensure that appropriate technologies are accessed by patients suspected of having CAD. This project came about when the Health Services Branch at the Ministry of Health and Long-Term Care asked MAS to provide an evidentiary platform on effectiveness and cost-effectiveness of non-invasive cardiac imaging modalities...
2010: Ontario Health Technology Assessment Series
Maros Ferencik, Christopher L Schlett, Fabian Bamberg, Quynh A Truong, John H Nichols, Antonio J Pena, Michael D Shapiro, Ian S Rogers, Sujith Seneviratne, Blair Alden Parry, Ricardo C Cury, Thomas J Brady, David F Brown, John T Nagurney, Udo Hoffmann
OBJECTIVES: The objective was to determine the association of four clinical risk scores and coronary plaque burden as detected by computed tomography (CT) with the outcome of acute coronary syndrome (ACS) in patients with acute chest pain. The hypothesis was that the combination of risk scores and plaque burden improved the discriminatory capacity for the diagnosis of ACS. METHODS: The study was a subanalysis of the Rule Out Myocardial Infarction Using Computer-Assisted Tomography (ROMICAT) trial-a prospective observational cohort study...
August 2012: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Katarzyna Szymanowska, Anna Piatkowska, Anna Nowicka, Szczepan Cofta, Michał Wierzchowiecki
BACKGROUND: Heart rate turbulence (HRT) assessment is used as noninvasive method based on physiological sinus node response to the premature ventricular beat. Blunted HRT may indicate the autonomic nervous system impairment and can be helpful in identifying high-risk patients. Obstructive sleep apnea syndrome (OSAS) leads to cardiovascular complications. Autonomic nervous system and baroreflex dysfunctions may play the main role in the development of cardiovascular diseases. In the present study we aimed to assess HRT parameters in OSAS patients with and without coronary artery disease (CAD) in comparison to control group...
2008: Cardiology Journal
Iu N Belenkov, E V Privalova, V Iu Kaplunova, A A Fomin
AIM: To detect relations between intracardiac hemodynamics and clinicoanamnestic features of patients with hypertrophic cardiomyopathy (HCMP). MATERIAL AND METHODS: We observed 84 patients with different clinical variants of a HCMP course. Of them, 15 patients were treated surgically. The patients were followed up from 3 to 24 years (mean 8.4 +/- 1.1 years). All the patients have undergone standard ECG, transthoracic echocardiography with doppler echocardiography, 24-h ECG monitoring, part of them--stress echocardiography (exercise and/or dobutamine), MRT of the heart, coronaroangiography and probing of the heart...
2008: Terapevticheskiĭ Arkhiv
Abdul Wajid Khan Faisal, Abdul Rehman Abid, Muhammad Azhar
BACKGROUND: To study the factors which predetermine the coronary artery disease in patients having positive Exercise Tolerance Test (ETT) after comparing the ETT test results and coronary angiographic findings in true positive and false positive groups. METHODS: This Cross-sectional study was conducted at Punjab Institute of Cardiology, Lahore from January 1, 2004 to December 31, 2004. All patients who had ETT done for chest pain diagnosis were studied. Patients were advised coronary angiography if ETT was positive for exercise induced ischaemia...
October 2007: Journal of Ayub Medical College, Abbottabad: JAMC
Luca Barnabei, Stefania Marazìa, Raffaele De Caterina
A common problem in diagnostic medicine, when performing a diagnostic test, is to obtain an accurate discrimination between 'normal' cases and cases with disease, owing to the overlapping distributions of these populations. In clinical practice, it is exceedingly rare that a chosen cut point will achieve perfect discrimination between normal cases and those with disease, and one has to select the best compromise between sensitivity and specificity by comparing the diagnostic performance of different tests or diagnostic criteria available...
November 2007: Journal of Cardiovascular Medicine
George Polizos, Myrvin H Ellestad
BACKGROUND: The aim of the study was to evaluate the contribution of relative lead strengths to exercise-induced ECG changes (ST depression) to predict the degree of myocardial ischemia as compared to the angiograms. This was accomplished by comparing the magnitude of ST depression to the ST/R ratio. Studies have shown that the diagnostic strength of a lead is directly related to the R wave amplitude and that sensitivity is significantly improved. METHODS: Three hundred patients, who underwent treadmill exercise testing and coronary angiography revealing significant coronary narrowing (> or = 70% luminal diameter narrowing), were studied, along with 150 patients clear of significant coronary artery disease (<70% luminar diameter narrowing)...
January 2007: Annals of Noninvasive Electrocardiology
Marc Dewey, Hans-Peter Dübel, Tania Schink, Gert Baumann, Bernd Hamm
AIMS: To prospectively compare multislice computed tomography (MSCT) and exercise electrocardiography (ex-ECG) for diagnosis of coronary artery disease (CAD) with conventional coronary angiography as the reference standard. METHODS AND RESULTS: A consecutive cohort of 80 patients with suspected CAD was examined with MSCT using 16 x 0.5 mm detector collimation, ex-ECG, and conventional coronary angiography according to standard protocols. Results were compared using the paired McNemar's test, the chi(2) test, and 95%CIs...
October 2007: European Heart Journal
Alberto Conti, Lucia Sammicheli, Chiara Gallini, Egidio Natalino Costanzo, David Antoniucci, Giuseppe Barletta
OBJECTIVES: The aim of the study was to compare head-to-head the performance of exercise tolerance test-stress echocardiography (ex-Echo) and exercise stress-perfusion nuclear imaging (exercise-single-photon emission computed tomography [ex-SPECT]) for the diagnosis of coronary artery disease (CAD) in patients evaluated at the chest pain unit with delay from chest pain (CP) onset. BACKGROUND: As an early triage strategy for CAD in emergency medicine, ex-Echo could have the advantage of widespread availability and low costs...
May 2005: American Heart Journal
J Charvat, K Michalova, K Taborska, J Chlumsky, M Kvapil
BACKGROUND: Diabetes mellitus is known to be a risk factor of the coronary heart disease even in the asymptomatic patients. Only a limited number of reports comparing the significance of different noninvasive stress tests in establishing the diagnosis of the advanced coronary lesions exists. OBJECTIVES: The aim of the study was to compare the significance of 12-lead exercise ECG and the myocardial SPECT in order to detect the significant coronary heart disease in asymptomatic type 2 diabetics...
2004: Bratislavské Lekárske Listy
M Dewey, B Hamm
BACKGROUND AND OBJECTIVE: The cost-effectiveness of medical procedures is becoming a crucial factor besides their efficacy in clinical decision-making. We performed a cost-effectiveness analysis of the most common diagnostic modalities used in assessing coronary artery disease (CAD). METHODS: A decision tree model for determining the cost-effectiveness in CAD diagnosis was applied to the situation in Germany to calculate the cost-effectiveness of exercise ECG (ExECG), stress echocardiography (ECHO), myocardial scintigraphy (SPECT), and coronary angiography (ANGIO)...
June 18, 2004: Deutsche Medizinische Wochenschrift
Bülent B Altunkeser, Kurtuluş Ozdemir, Hüseyin Ozdil, Hasan Gök, Mustafa Aydin
BACKGROUND: QT and corrected QT dispersion (QTD, QTcD) obtained by using the standard 12-lead ECG is a marker of nonhomogenous ventricular repolarization. QTD obtained from exercise ECG increases the diagnostic reliability of ST-segment changes. The aim of this study was to investigate the diagnostic accuracy of the QTD and QTcD obtained by a 12-lead ECG during the peak exercise in determining remote vessel disease in patients with healed Q-wave MI. METHODS: Eighty patients with healed Q-wave MI (mean age 54 +/- 8 years; 71 men, 9 women; 29 anterior; 51 inferior MI) who underwent exercise stress testing and coronary angiography were included in this study...
July 2002: Annals of Noninvasive Electrocardiology
P Witek
Nowadays the cardiovascular diseases particularly ischaemic heart disease (IHD) are the most frequent causes of death in Poland. Some of patients with IHD are completely asymptomatic. These subjects are more susceptible to sudden coronary events due to lack of diagnosis and treatment. Cohn divided patients with asymptomatic ischaemia (AI) into three groups: completely asymptomatic, asymptomatic patients after myocardial infarction, patients with painful angina who have some ischaemic events asymptomatic. Some causes of AI are: increased pain threshold, increased beta-endorphin levels, impairment of pain pathways, smaller ischaemic regions in comparison with painful angina, psychological factors, transient platelet microaggregates...
2001: Przegla̧d Lekarski
W F Fearon, D P Lee, V F Froelicher
OBJECTIVES: The aim of this study is to demonstrate the effect of resting ST segment depression on the diagnostic characteristics of the exercise treadmill test. BACKGROUND: Previous studies evaluating the effect of resting ST segment depression on the diagnostic characteristics of exercise treadmill test have been conducted on relatively small patient groups and based only on visual electrocardiogram (ECG) analysis. METHODS: A retrospective analysis of data collected prospectively was performed on consecutive patients referred for evaluation of chest pain...
April 2000: Journal of the American College of Cardiology
V Todino, G Rubini, A Cuocolo
BACKGROUND: Inversion of gated myocardial perfusion imaging has been proposed for the evaluation of left ventricular function. This study compared the results of inversion technique of gated left anterior oblique 45 degrees images (G-LAO 45 degrees) with those provided by equilibrium radionuclide angiography in the assessment of global left ventricular function in the same patients with suspected or known coronary artery disease. METHODS AND RESULTS: A total of 107 patients (85 men and 22 women, mean age 59 +/- 9 years) with suspected or documented coronary artery disease were studied...
November 1999: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
S Schröder, M D Enderle, C Meisner, A Baumbach, C Herdeg, M Oberhoff, R Ossen, M Pfohl, K R Karsch
BACKGROUND AND OBJECTIVE: A positive correlation between the presence of coronary artery disease (CAD) and peripheral endothelial dysfunction (ED) of the brachial artery has been shown in several studies. Aim of the present study was to evaluate whether the non-invasive determination of ED could also be used as a screening test in patients suspected of having CAD. PATIENTS AND METHODS: 122 patients were included. 112 had an exercise-ECG before hospital admission...
July 30, 1999: Deutsche Medizinische Wochenschrift
M M Israpilov, Iu S Gerashchenko, T V Fofanova, A P Iurenev
AIM: To elucidate contribution of left ventricular hypertrophy (LVH) vs myocardial ischemia to rhythmic disorders in patients with essential hypertension (EH) and LVH. MATERIALS AND METHODS: Echocardiography, coronarography, treadmill test, 24-h ECG monitoring were included in examination of 69, 69, 68 and 63 patients, respectively. All of them had EH stage II and LVH. The comparison was made between the groups composed by LVH degree and by the presence or absence of coronary artery atherosclerosis (CAA)...
1999: Terapevticheskiĭ Arkhiv
R Kowalczyk, Z Gawor, Z Maziarz, A Goch, R Drobiński, B Małkowski, T Grycewicz, J H Goch, M Kośmider, J Adamus
UNLABELLED: The aim of the study was to compare the perfusion scintigraphy (using SPECT method with Tc-99-MIBI) during left atrial transoesophageal pacing test (LAPT) with pacing electrocardiography (ECG), echocardiography (ECHO) and electrocardiography exercise test (ExT) in ischaemic heart disease (IHD) diagnostics. The effect of LATP on heart haemodynamic parameters and the correlation between scintigraphic, echocardiographic and electrocardiographic parameters during LAPT test have been also assessed...
March 1998: Polskie Archiwum Medycyny Wewnętrznej
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