ST segment elevation in lead aVR during exercise testing is associated with LAD stenosis

European Journal of Nuclear Medicine and Molecular Imaging

Volumn 34, Issue 3, 2007, Pages 338-345

  Neill, Johanne ^a,b   Shannon, Heather J ^a   Morton, Amanda ^a   Muir, Alison R ^a   Harbinson, Mark ^a,b   Adgey, Jennifer A ^a  

^a ROYAL VICTORIA HOSPITAL   (United Kingdom)

^b QUEEN'S UNIVERSITY BELFAST   (United Kingdom)

Author keywords

Cardiovascular; Diagnostic techniques; Electrocardiography; Lead aVR; Myocardial ischaemia; Radionuclide imaging

Indexed keywords

METHOXY ISOBUTYL ISONITRILE TECHNETIUM TC 99M;

ADULT; ANGIOCARDIOGRAPHY; ARTICLE; CONTROLLED STUDY; CORONARY ARTERY OBSTRUCTION; DIAGNOSTIC VALUE; ECG ABNORMALITY; ELECTROCARDIOGRAPHY MONITORING; EXERCISE TEST; FEMALE; HEART MUSCLE PERFUSION; HUMAN; IMAGING; LEFT ANTERIOR DESCENDING CORONARY ARTERY; LOGISTIC REGRESSION ANALYSIS; MAJOR CLINICAL STUDY; MALE; PREDICTION; SINGLE PHOTON EMISSION COMPUTER TOMOGRAPHY; ST SEGMENT DEPRESSION; ST SEGMENT ELEVATION; THORAX PAIN; TREADMILL EXERCISE;

AGED; ARRHYTHMIA; CORONARY STENOSIS; ELECTROCARDIOGRAPHY; EXERCISE TEST; FEMALE; GREAT BRITAIN; HUMANS; MALE; MIDDLE AGED; RISK ASSESSMENT; RISK FACTORS; STATISTICS;

EID: 33847147572     PISSN: 16197070     EISSN: None     Source Type: Journal    
DOI: 10.1007/s00259-006-0188-1     Document Type: Article

References (15)

1. Dunn RF, Freedman B, Bailey IK, Uren RF, Kelly DT. Localisation of coronary disease with exercise electrocardiography: correlation with thallium-201 myocardial perfusion scanning. Am J Cardiol 1981;48:837-43.
2. 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.
3. Yamaji H, Iwasaki K, Kusachi S, Murakami T, Hirami R, Hamamoto H, et al. Prediction of acute left main coronary artery obstruction by 12-lead electrocardiography: ST segment elevation in lead aVR with less ST segment elevation in lead V1. J Am Coll Cardiol 2001;38:1348-54.
4. Gorgels AP, Vos MA, Mulleneers R, de Zwaan C, Bar FW, Wellens HJ. Value of the electrocardiogram in diagnosing the number of severely narrowed coronary arteries in rest angina pectoris. Am J Cardiol 1993;72:999-03.
5. Gaitonde RS, Sharma N, Ali-Hasan S, Miller JM, Jayachandran JV, Kalaria VG. Prediction of significant left main coronary artery stenosis by the 12-lead electrocardiogram in patients with rest angina pectoris and the withholding of clopidogrel therapy. Am J Cardiol 2003;92:846-8.
6. Nikus KC, Sclarovsky S. ST elevation in lead aVR as a sign of left main disease-perpetuating an error? Am J Cardiol 2004;94:542-3.
7. Barrabés JA, Figueras J, Moure C, Cortadellas J, Soler-Soler J. Prognostic value of lead aVR in patients with a first non-ST-segment elevation acute myocardial infarction. Circulation 2003;108:814-9.
8. Engelen DJ, Gorgels AP, Cheriex EC, De Muinck ED, Ophuis AJ, Dassen WR, et al. Value of the electrocardiogram in localising the occlusion site in the left anterior descending coronary artery in acute anterior myocardial infarction. J Am Coll Cardiol 1999;34:389-95.
9. Michaelides, AP, Psomadaki ZD, Aigyptiadou MN, Richter DJ, Andrikopoulos GK, Dilaveris PE, et al. Significance of exercise-induced ST changes in leads aVR, V5 and V1. Discrimination of patients with single-or multivessel coronary artery disease. Clin Cardiol 2003;26(5):226-30.
10. Halon D, Mevorach D, Rodeanu M, Lewis B. Improved criteria for localisation of coronary artery disease from the exercise electrocardiogram. Cardiology 1994;84:331-8.
11. Michaelides AP, Psomadaki ZD, Richter DJ, Dilaveris PE, Andrikopoulos GK, Stefanadis C, et al. Significance of exercise-induced simultaneous ST-segment changes in lead aVR and V5. Int J Cardiol 1999;71:49-56.
12. Nakamori H, Iwasaka T, Shimada T, Kamihata H, Karakawa M, Matsuura T, et al. Clinical significance of S-T segment elevation in lead aVR in anterior myocardial infarction: assessment by thallium-201 exercise scintigraphy. Cardiology 1995;86:147-51.
13. Kosuge M, Kimura K, Ishikawa T, Endo T, Hongo Y, Shigemasa T, et al. ST-segment depression in lead aVR predicts predischarge left ventricular dysfunction in patients with reperfused anterior acute myocardial infarction with anterolateral ST-segment elevation. Am Heart J 2001;142:51-7.
14. Benoit T, Vivegnis D, Foulon J, Rigo P. Quantitative evaluation of myocardial single-photon emission tomographic imaging: application to the measurement of perfusion defect size and severity. Eur J Nucl Med 1996;23:1603-12.
15. Viik J, Lehtinen R, Tech L, Turjanmaa V, Niemela K, Malmivuo J. The effect of lead selection on traditional and heart rate adjusted ST segment analysis in the detection of coronary artery disease during exercise testing. Am Heart J 1997;134:488-94.