Novel methodology for the detection of exercise-induced myocardial wall motion abnormalities by surface electrocardiogram during exercise test

作者：Michaelides Andreas P; Massias Spyros; Antoniades Charalambos; Tsiachris Dimitris; Dilaveris Polychronis^*; Aggelis Athanasios; Liakos Charalampos; Marinou Kyriakoula; Raftopoulos Leonidas; Soulis Dimitrios; Stefanadis Christodoulos

来源：Journal of Electrocardiology, 2011, 44(3): 377-382.

DOI：10.1016/j.jelectrocard.2010.11.011

• Exercise test
• Ischemia
• Electrocardiogram
• Wall motion abnormalities

Background: We investigated whether ischemia-induced wall motion abnormalities during exercise test modify electrical vector variation.
Methods: We performed treadmill exercise test and thallium 201 scintigraphy in 150 normotensives. Beat-to-beat change of direction of S wave in V(1) (reference lead) was compared with that of R wave in V(5) and aVF, representative of anterior and inferior walls, respectively. The percentage of neighboring QRS couples where S wave in V(1) and R wave in V(5) or aVF change toward the same direction (increase or decrease) constitutes V1-V5 and V1-aVF indexes.
Results: V1-V5 and V1-aVF indexes were significantly decreased in subjects with reversible anterior or inferior ischemia, respectively. A decrease in V1-V5 index >= 0.14 defines those with anterior wall ischemia (sensitivity, 100%; specificity, 75.5%), whereas a decrease in V1-aVF index >= 0.05 defines those with inferior wall ischemia (sensitivity, 92.3%; specificity, 61.5%).
Conclusions: These novel electrocardiographic exercise test indexes improved significantly their sensitivities.

• 出版日期2011-6