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(Circulation. 1971;44:585.)
© 1971 American Heart Association, Inc.

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S-T-Segment Depression with Near-Maximal Exercise in Detection of Preclinical Coronary Heart Disease

ALBERT A. KATTUS M.D.¹; CHARLES R. JORGENSEN M.D.¹; RALPH E. WORDEN M.D.¹; ANTHONY B. ALVARO M.D.¹

¹ From the Department of Medicine, U.C.L.A. School of Medicine, Los Angeles, California.

Three hundred and fourteen male insurance underwriters had near-maximal treadmill exercise tests after having been evaluated for coronary risk factors. Thirty subjects developed ischemic-type S-T-segment depression during or after exercise not associated with anginal pain. The abnormal electrocardiographic response correlated significantly with elevated serum cholesterol, abnormal rest electrocardiogram, and history of cardiac symptoms; but not with smoking, high blood pressure, physical inactivity, or family history of coronary disease.

In 2.5 years' follow-up there have been among the 30 ischemic responders to exercise testing three coronary deaths, four myocardial infarctions, two who developed angina pectoris, and one who had a coronary angiogram showing multiple obstructions. None of the normal responders to exercise testing has had a coronary event.

Key Words: Risk factors • Coronary events

Submitted on February 17, 1971
Accepted on June 4, 1971