Circulation, Vol 56, 552-559, Copyright © 1977 by American Heart Association
ML Simoons and PG Hugenholtz
In order to improve the value of exercise tests for the detection of
coronary artery disease (CAD) a system for on-line computer processing of
the Frank lead exercise ECG was developed. Data were analyzed from 95
patients with CAD and 129 ostensibly healthy men. All subjects had a normal
ECG at rest. Visual ECG interpretation during exercise yielded a
sensitivity of 50% and a specificity of 95%. A large number of QRS and ST
measurements were compared by discriminant function analysis in a group of
86 normal subjects and 52 patients (designated training group). Best
results were obtained with a combination of two ST amplitudes from lead X:
sensitivity, 85%, specificity, 90%. This was confirmed in a test group of
43 patients and 43 normal subjects. The results of the discriminant
function were expressed as the likelihood ratio for an abnormal or normal
ST segment at a given heart rate, a figure which provides a quantitative
assessment of the degree of exercise-induces ischemia. This is a more
realistic approach than classification into normal or abnormal since
persons with and without CAD fall along the same continuous spectrum.
ARTICLES
Estimation of the probability of exercise-induced ischemia by quantitative ECG analysis
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