Abstract
We investigated the correlation of exercise-induced ST-segment changes in lead V 1, with the detection of the significantly narrowed vessel that induced ischemia during exercise in myocardial areas supplied by this vessel. We studied 198 patients who underwent exercise testing, thallium-201 scintigraphy, and coronary arteriography. The patients were divided into three groups. In group 1 (ST-segment elevation in lead V 1), 84% had left anterior descending coronary artery disease ( P < .001); in group 2 (ST-segment depression in lead V 1), 76% had right coronary artery disease ( P < .001); and in group 3 (no ST-segment changes in lead V 1), there were no significant differences concerning the narrowed vessel. Thallium-201 scintigraphy data confirmed the existence of the reversible perfusion defect(s) in an area(s) of myocardium supplied by the respective coronary arteries ( P < .001). Exercise-induced ST-segment elevation or depression in V 1 may identify the obstructed vessel in patients with single-vessel disease and without prior myocardial infarction.
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