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. 1977 Sep;127(3):199–203.

Electrographic Exercise Stress Testing and Coronary Arteriography

Correlation Among 114 Men With Chest Pain

W V R Vieweg 1,2, J S Alpert 1,2, Allen D Johnson 1,2, A D Hagan 1,2
PMCID: PMC1237773  PMID: 906456

Abstract

The electrocardiographic response to exercise stress testing (EST) was compared with coronary arteriographic findings in 114 men referred for evaluation of chest pain. The men were divided into two groups: group A (69 men) in whom the coronary arteriograms showed at least one major vessel with greater than 70 percent reduction in cross sectional area, and group B (45 men) in whom there was no evidence of coronary arterial narrowing. In both groups A and B the description of chest pain was judged to be at least consistent with the diagnosis of angina pectoris if not always representing classical angina pectoris. Only men with a positive finding to EST and those with a negative EST response after achieving at least 90 percent of predicted maximum heart rate were included in the calculations. Our results were strikingly similar to those obtained from an extensive review of the literature and showed the following: sensitivity, 80.4 percent; specificity, 88.6 percent; predictive value of a positive test result, 91.1 percent; predictive value of a negative test result, 75.6 percent, and efficiency of the test 83.7 percent.

The maximal EST is a useful predictor of coronary artery disease when a male population is evaluated for chest pain. When a population is selected on some basis other than chest pain (such as elevated lipids or age), EST is a much less useful predictor of coronary artery disease.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ascoop C. A., Simoons M. L., Egmond W. G., Bruschke A. V. Exercise test, history, and serum lipid levels in patients with chest pain and normal electrocardiogram at rest: comparison to findings at coronary arteriography. Am Heart J. 1971 Nov;82(5):609–617. doi: 10.1016/0002-8703(71)90329-2. [DOI] [PubMed] [Google Scholar]
  2. Borer J. S., Brensike J. F., Redwood D. R., Itscoitz S. B., Passamani E. R., Stone N. J., Richardson J. M., Levy R. I., Epstein S. E. Limitations of the electrocardiographic response to exercise in predicting coronary-artery disease. N Engl J Med. 1975 Aug 21;293(8):367–371. doi: 10.1056/NEJM197508212930801. [DOI] [PubMed] [Google Scholar]
  3. Bruce R. A., Hornsten T. R. Exercise stress testing in evaluation of patients with ischemic heart disease. Prog Cardiovasc Dis. 1969 Mar;11(5):371–390. doi: 10.1016/0033-0620(69)90027-9. [DOI] [PubMed] [Google Scholar]
  4. Friesingerg G. C., Smith R. F. Correlation of electrocardiographic studies and arteriographic findings with angina pectoris. Circulation. 1972 Dec;46(6):1173–1184. doi: 10.1161/01.cir.46.6.1173. [DOI] [PubMed] [Google Scholar]
  5. Froelicher V. F., Jr, Yanowitz F. G., Thompson A. J., Lancaster M. C. The correlation of coronary angiography and the electrocardiographic response to maximal treadmill testing in 76 asymptomatic men. Circulation. 1973 Sep;48(3):597–604. doi: 10.1161/01.cir.48.3.597. [DOI] [PubMed] [Google Scholar]
  6. Galen R. S. Letter: Predictive value of laboratory tests. Am J Cardiol. 1975 Oct 6;36(4):536–538. doi: 10.1016/0002-9149(75)90916-9. [DOI] [PubMed] [Google Scholar]
  7. Linhart J. W., Turnoff H. B. Maximum treadmill exercise test in patients with abnormal control electrocardiograms. Circulation. 1974 Apr;49(4):667–672. doi: 10.1161/01.cir.49.4.667. [DOI] [PubMed] [Google Scholar]
  8. Martin C. M., McConahay D. R. Maximal treadmill exercise electrocardiography. Correlations with coronary arteriography and cardiac hemodynamics. Circulation. 1972 Nov;46(5):956–962. doi: 10.1161/01.cir.46.5.956. [DOI] [PubMed] [Google Scholar]
  9. McHenry P. L., Phillips J. F., Knoebel S. B. Correlation of computer-quantitated treadmill exercise electrocardiogram with arteriographic location of coronary artery disease. Am J Cardiol. 1972 Nov;30(7):747–752. doi: 10.1016/0002-9149(72)90149-x. [DOI] [PubMed] [Google Scholar]
  10. Piessens J., Van Mieghem W., Kesteloot H., De Geest H. Diagnostic value of clinical history, exercise testing and atrial pacing in patients with chest pain. Am J Cardiol. 1974 Mar;33(3):351–356. doi: 10.1016/0002-9149(74)90315-4. [DOI] [PubMed] [Google Scholar]
  11. Sketch M. H., Mohiuddin S. M., Lynch J. D., Zencka A. E., Runco V. Significant sex differences in the correlation of electrocardiographic exercise testing and coronary arteriograms. Am J Cardiol. 1975 Aug;36(2):169–173. doi: 10.1016/0002-9149(75)90521-4. [DOI] [PubMed] [Google Scholar]

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