This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Weiner, D. A. Articles by Ryan, T. J. Search for Related Content PubMed PubMed Citation Articles by Weiner, D. A. Articles by Ryan, T. J. Pubmed/NCBI databases Medline Plus Health Information Heart Attack

Circulation, Vol 58, 887-891, Copyright © 1978 by American Heart Association

ARTICLES

ST segment changes post-infarction: predictive value for multivessel coronary disease and left ventricular aneurysm

DA Weiner, C McCabe, MD Klein and TJ Ryan

To ascertain whether exercise testing might predict multivessel coronary disease and left ventricular aneurysm after a myocardial infarction, 154 patients with a single documented myocardial infarction who had both exercise testing and coronary angiography were grouped according to whether they had greater than or equal to 1 mm ST depression, greater than or equal to 1 mm ST elevation, or neither during exercise testing: 83 patients developed ST depression alone (group 1); 22 patients had ST elevation with concomitant ST depression in other leads (group 2); 19 patients had ST elevation alone (group 3); and 30 patients had no ST changes (group 4). Multivessel disease, defined as greater than or equal to 70% luminal narrowing in two or more coronary vessels, was present in 76% (63 of 83) of group 1, 91% (20 of 22) of group 2, 21% (four of 19) of group 3, and 13% (four of 30) of group 4. A left ventricular aneurysm was present in 31% (26 of 83) of group 1, 68% (15 of 22) of group 2, 79% (15 of 19) of group 3, and 40% (12 to 30) of group 1. We conclude that ST changes during exercise testing in patients after a myocardial infarction can reliably predict the extent of coronary disease and the presence of a left ventricular aneurysm; ST depression with or without ST elevation predicts multivessel disease; ST elevation alone or a negative exercise test suggests single vessel involvement; and ST elevation with or without ST depression predicts left ventricular aneurysm.

This article has been cited by other articles:

				M. E. Tavel Stress Testing in Cardiac Evaluation : Current Concepts With Emphasis on the ECG Chest, March 1, 2001; 119(3): 907 - 925. [Full Text] [PDF]

				A. Nakano, J.-D. Lee, H. Shimizu, T. Tsuchida, Y. Yonekura, Y. Ishii, and T. Ueda Reciprocal ST-segment depression associated with exercise-induced ST-segment elevation indicates residual viability after myocardial infarction J. Am. Coll. Cardiol., March 1, 1999; 33(3): 620 - 626. [Abstract] [Full Text] [PDF]

				H Yamagishi, K Akioka, M Takagi, A Tanaka, K Takeuchi, J Yoshikawa, and H Ochi Exercise four hour redistribution thallium-201 single photon emission computed tomography and exercise induced ST segment elevation in detecting the viable myocardium in patients with acute myocardial infarction Heart, January 1, 1999; 81(1): 17 - 24. [Abstract] [Full Text]

				K. M. Kuntz, J. Tsevat, L. Goldman, and M. C. Weinstein Cost-effectiveness of Routine Coronary Angiography After Acute Myocardial Infarction Circulation, September 1, 1996; 94(5): 957 - 965. [Abstract] [Full Text]

				R N Stevenson, V Umachandran, K Ranjadayalan, R H Roberts, and A D Timmis Early exercise testing after treatment with thrombolytic drugs for acute myocardial infarction: importance of reciprocal ST segment depression BMJ, May 7, 1994; 308(6938): 1189 - 1192. [Abstract] [Full Text]