| Abstract: | In the evaluation of the exercise stress test, conventional electrocardiographic criteria using 1 or 2 mm ST segment depression below the isoelectric line yields many false positive results and is not so useful to predict the severity of coronary artery disease. In this study, we have attempted to predict the presence and the severity of coronary artery disease from the post exercise T wave change. Fifty-six patients who had positive treadmill exercise test results by conventional ST segment criteria and underwent selective coronary arteriography were studied. T wave change was defined as inversion or biphasic change in one or more of leads aVF, V4, V5, V6 during the recovery phase, and in the cases who showed T wave changes, T wave configuration were also analysed. Seventeen of 28 patients with and 11 of 28 patients without significant coronary artery disease showed post exercise T wave changes. This difference was not statistically significant. But in the cases who showed T wave changes, the maximum amplitude of the negative component of T wave was significantly greater in the true positive group than in the false positive group. And the development of deeply negative component (more than 1.5 mm) indicated the presence of multivessel coronary artery disease. In the cases who showed the negative component of T wave less than 1 mm, the characteristics of T wave configuration including the amplitude, height of positive component, and the depth from the isoelectric line were different between the 2 groups. These results suggest that careful observation of T wave during the recovery phase is useful to improve the diagnostic accuracy of the exercise electrocardiogram. |
