The electrocardiographic exercise test in a population with reduced workup bias: Diagnostic performance, computerized interpretation, and multivariable prediction

Annals of Internal Medicine

Volumn 128, Issue 12 PART 1, 1998, Pages 965-974

  Froelicher, Victor F ^a   Lehmann, Kenneth G ^b   Thomas, Ronald ^c   Goldman, Steven ^d   Morrison, Douglas ^b   Edson, Robert ^a   Lavori, Philip ^a   Myers, Jonathan ^a   Dennis, Charles ^e   Shabetai, Ralph ^f   Do, Dat ^a   Froning, Jeffrey ^a  

^a VA PALO ALTO HEALTH CARE SYSTEM   (United States)

^b VETERANS AFFAIRS MEDICAL CENTER   (United States)

^c UNIVERSITY OF CALIFORNIA   (United States)

^d SOUTHERN ARIZONA VA HEALTH CARE SYSTEM   (United States)

^e DEBORAH HEART AND LUNG CENTER   (United States)

^f VA SAN DIEGO HEALTHCARE SYSTEM   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; AGED; ANGINA PECTORIS; ANGIOCARDIOGRAPHY; AREA UNDER THE CURVE; ARTICLE; CLINICAL FEATURE; COMPUTER ANALYSIS; CORONARY ARTERY DISEASE; DIAGNOSTIC VALUE; EXERCISE ELECTROCARDIOGRAPHY; EXERCISE TEST; HEMODYNAMIC MONITORING; HUMAN; INTERMETHOD COMPARISON; MAJOR CLINICAL STUDY; MULTIVARIATE ANALYSIS; PILOT STUDY; PRIORITY JOURNAL; R WAVE; ST SEGMENT;

EID: 0005492003     PISSN: 00034819     EISSN: None     Source Type: Journal    
DOI: 10.7326/0003-4819-128-12_part_1-199806150-00001     Document Type: Article

References (37)

1. Fletcher GF, Froelicher VF, Hartley LH, Haskell WL, Pollock ML. Exercise standards. A statement for health professionals from the American Heart Association. Circulation. 1990;82:2286-322.
2. Gibbons RJ, Balady GJ, Beasley JW, Bricker JT, Duvernoy WF, Froelicher VF, et al. ACC/AHA Guidelines for Exercise Testing. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Exercise Testing). J Am Coll Cardiol. 1997; 30:260-311.
3. Yamada H, Do D, Morlse A, Atwood JE, Froelicher V. Review of studies using multivariable analysis of clinical and exercise test data to predict angiographic coronary artery disease. Prog Cardiovasc Dis. 1997;39:457-81.
4. Okin PM, Kligfield P. Heart rate adjustment of ST segment depression and performance of the exercise electrocardiogram: a critical evaluation. J Am Coll Cardiol. 1995;25:1726-35.
5. DelCampo J, Do D, Umann T, McGowan V, Froning J, Froelicher V. Comparison of computerized and standard visual criteria of exercise ECG for diagnosis of coronary artery disease. Annals of Non-Invasive Electrocardiography. 1996;1:430-42.
6. Philbrick JT, Horowitz SW, Feinstein AR. Methodological problems of exercise testing for coronary artery disease: groups, analysis and bias. Am J Cardiol. 1989;64:1117-22.
7. Myers J, Do D, Herbert W, Ribisl P, Froelicher VF. A nomogram to predict exercise capacity from a specific activity questionnaire and clinical data. Am J Cardiol. 1994;73:591-6.
8. Mark DB, Hlatky MA, Harrell FE Jr, Lee KL, Califf RM, Pryor DB, et al. Exercise treadmill score for predicting prognosis in coronary artery disease. Ann Intern Med. 1987;106:793-800.
9. Reid MC, Lachs MS, Feinstein AR. Use of methodological standards in diagnostic test research. Getting better but still not good. JAMA. 1995;274: 645-51.
10. Fletcher GF, Balady G, Froelicher VF, Hartley LH, Haskell WL, Pollock ML. Exercise standards. A statement for healthcare professionals from the American Heart Association. Writing Group. Circulation. 1995;91:580-615.
11. Froning JN, Froelicher VF, Olson MD. A real-time data-logger system using an optical disk WORM for archiving continuous 12-lead ECG data during exercise testing. J Electrocardiol. 1988;21:S141-8.
12. Froelicher VF, Myers J, Follansbee WP, Labovitz AJ. Exercise and the Heart. St. Louis: Mosby; 1993:48-69.
13. Herbert WG, Dubach P, Lehmann KG, Froelicher VF. Effect of beta-blockade on the interpretation of the exercise ECG: ST level versus delta ST/HR index. Am Heart J. 1991;122(4 pt 1):993-1000.
14. Ribisl PM, Liu J. Mousa I, Herbert WG, Miranda CP, Froning JN, Froelicher VF. Comparison of computer ST criteria for diagnosis of severe coronary artery disease. Am J Cardiol. 1993;71:546-51.
15. Gianrossi R, Detrano R, Mulvihill D, Lehmann K, Dubach P, Colombo A, et al. Exercise-induced ST depression in the diagnosis of coronary artery disease. A meta-analysis. Circulation. 1989;80:87-98.
16. Morise AP, Diamond GA. Comparison of the sensitivity and specificity of exercise electrocardiography in biased and unbiased populations of men and women. Am Heart J. 1995;130:741-7.
17. Ascoop CA, Distelbrink CA, De Lang PA. Clinical value of quantitative analysis of ST slope during exercise. Br Heart J. 1977;39:212-7.
18. Simoons M. Optimal measurements for detection of coronary artery disease by exercise electrocardiography. Comput Biomed Res. 1977;10:483-99.
19. Simoons ML, Hugenholtz PG. Estimation of the probability of exercise-induced ischemia by quantitative ECG analysis. Circulation. 1977;56:552-9.
20. Detry JM, Robert A, Luwaert RJ, Rousseau MF, Brasseur LA, Melin JA, et al. Diagnostic value of computerized exercise testing in men without previous myocardial infarction. A multivariate, compartmental and probabilistic approach. Eur Heart J. 1985;6:227-38.
21. Deckers JW, Rensing BJ, Tijssen JG, Vinke RV, Azar AJ, Simoons ML. A comparison of methods of analyzing exercise tests for diagnosis of coronary artery disease. Br Heart J. 1989;62:438-44.
22. Detrano R, Salcedo E, Leatherman J, Day K. Computer-assisted versus unassisted analysis of the exercise electrocardiogram in patients without myocardial infarction. J Am Coll Cardiol. 1987;10:794-9.
23. Detrano R, Salcedo E, Passalacqua M, Friis R. Exercise electrocardiographic variables: a critical appraisal. J Am Coll Cardiol. 1986;8:836-47.
24. Pruvost P, Lablanche JM, Beuscart R, Fourrier JL, Traisnel G, Lombart F, et al. Enhanced efficacy of computerized exercise test by multivariate analysis for the diagnosis of coronary artery disease. A study of 558 men without previous myocardial infarction. Eur Heart J. 1987;8:1287-94.
25. Okin PM, Kligfield P. Heart rate adjustment of ST segment depression and performance of the exercise electrocardiogram: a critical evaluation. J Am Coll Cardiol. 1995;25:1726-35.
26. Lachterman B, Lehmann KG, Detrano R, Neutel J, Froelicher VF. Comparison of ST segment/heart rate index to standard ST criteria for analysis of exercise electrocardiogram. Circulation. 1990;82:44-50.
27. Morise AP, Duval RD. Accuracy of ST/heart rate index in the diagnosis of coronary artery disease. Am J Cardiol. 1992;69:603-6.
28. Bobbio M, Detrano R. A lesson from the controversy about heart rate adjustment of ST segment depression. Circulation. 1991;84:1410-3.
29. Rodriguez M, Froning J, Froelicher V. ST0 or ST60 [Editorial]. Am Heart J. 1993;126(3 Pt 1):752-4.
30. Morris CK, Myers J, Froelicher VF, Kawaguchi T, Ueshima K, Hideg A, et al. Nomogram based on metabolic equivalents and age for assessing aerobic exercise capacity in men. J Am Coll Cardiol. 1993;22:175-82.
31. Hollenberg M, Budge WR, Wisneski JA, Gertz EW. Treadmill score quantifies electrocardiographic response to exercise and improves test accuracy and reproducibility. Circulation. 1980;61:276-85.
32. Sheffield LT, Holt JH, Lester FM, Conroy DV, Reeves TJ. On-line analysis of the exercise electrocardiogram. Circulation. 1969;40:935-44.
33. Miranda CP, Liu J, Kadar A, Janosi A, Froning J, Lehmann KG, Froelicher VF. Usefulness of exercise-induced ST-segment depression in the inferior leads during exercise testing as a marker for coronary artery disease. Am J Cardiol. 1992;69:303-8.
34. Lachterman B, Lehmann KG, Abrahamson D, Froelicher VF. "Recovery only" ST-segment depression and the predictive accuracy of the exercise test. Ann Intern Med. 1990;112:11-6.
35. Berman JA, Wynne J, Malls G, Cohn PF. Improving diagnostic accuracy of the exercise test by combining R-wave changes with duration of ST segment depression in a simplified index. Am Heart J. 1983;105:60-6.
36. Do D, West JA, Morise A, Atwood E, Froelicher V. A consensus approach to diagnosing coronary artery disease based on clinical and exercise test data. Chest. 1997;111:1742-9.
37. Willems JL, Abreu-Lima C, Arnaud P, van Bemmel JH, Brohet C, Degani R, et al. The diagnostic performance of computer programs for the interpretation of electrocardiograms. N Engl J Med. 1991;325:1767-73.