Postexercise electrocardiography in patients with arteriographically documented coronary artery disease.

Abstract

The relationship between coronary cinearteriographic findings and postexercise electrocardiographic (ECG) evidence of ischemia was examined in 65 persons with angina pectoris and documented coronary atherosclerosis. Fifty-eight percent of the patients had an abnormal postexercise ECG response defined as ≥ 1.0 mm of flat R-ST segment depression. The frequency and degree of postexercise ECG abnormality correlated directly with the number of significantly diseased coronary arteries. The presence of collateral vessels did not protect against the induction of ischemic ECG changes by the mild exercise stress used. The 2-step test provided sufficient stress for 14 patients (22%) to result in a prolonged (≥ 8 min) postexercise ischemic response. Twelve of 39 patients (31%) with widespread coronary atherosclerosis (3-vessel disease) had a normal postexercise ECG, whereas 13 (33%) had ≥ 2.0 mm of segmental R-ST depression. Since such ECG findings have been shown by others to have prognostic significance, the postexercise ECG adds a significant dimension to our understanding of coronary artery disease and provides information not available from coronary angiography alone.