International Research Journal of Public and Environmental Health
Vol.2 (12),pp. 232-237,December 2015
Available online at https://www.journalissues.org/IRJPEH/
Article 15/ID/JPRH096/ 06 pages
Author(s) agree that this article remain permanently open access under the terms of the Creative Commons Attribution License 4.0 International License.
Original Research Article
Diagnostic value of combined exercise-induced ST segment changes and heart rate recovery post treadmill exercise for the detection of coronary artery disease in the real world: A single center experience
Yijun Yu, Dingfeng Peng*, Tao Liu, Yupeng Bai, Wusong Zou, Bo Gao, Jie Wu, Pengfei Zhu, Mingjing Zhang and Ye Gu
Department of Cardiology, Heart Center at Puai Hospital, Puai Hospital, Huazhong University of Science and Technology, Wuhan 430030, China.
*Corresponding Author E-mail: dfpeng2003cn_puai(at)163.com
Diagnostic specificity of treadmill exercise test for coronary artery disease (CAD) remains a challenge in daily clinical practice. Present study evaluated the diagnostic value of combining ST segment changes and heart rate recovery (HRR) during/post treadmill exercise test. A total of 105 patients with suspected CAD underwent treadmill exercise test and coronary angiography (CAG) during May 2012 to July 2014. Patients were divided into CAD group (n=48) and non-CAD (N-CAD) group (n=57) according to CAG results. ST segment changes and HRR were analyzed. HRR was significantly lower in CAD group compared non-CAD group (P=0.013) and the prevalence of abnormal HRR (≤24) tended to be higher in CAD group (52.1% vs. 40.3%, p=0.229). Using exercise-induced ST segment changes as CAD diagnosis criteria, the sensitivity was 70.8%, specificity was 52.6%, positive predictive value was 55.7%, and negative predictive value was 68.2%. Combining exercise-induced ST segment changes and abnormal heart rate recovery post treadmill exercise as CAD diagnose criteria, the sensitivity was 41.7%, specificity was 84.2%, positive predictive value was 69.0% and negative predictive value was 63.2%. Combing ST segment changes and HRR can improve the specificity of CAD diagnosis by treadmill exercise test, therefore, this might be a suitable procedure to exclude the CAD diagnosis in patients with suspected CAD.
Key words: Treadmill exercise test; ST segment changes; Heart rate recovery; Coronary artery disease