This study compared thallium stress testing and exercise changes in QRS duration using a computerized ‘optic scanner’ in three groups. Group 1 consisted of 108 subjects with positive exercise ECG tests by ST-T segment criteria and with proven coronary artery disease. Group 2 included 19 subjects with nondiagnostic exercise ECG ST-T changes and with proven coronary artery disease. Group 3 was formed by 38 healthy controls. Group 1: Mean increase in exercise QRS width of 12.4 ± 14 ms. Group 3: Mean decrease in exercise QRS width of 4.9 ± 9.3 ms(p < 0.0001). Group 2: Mean QRS prolongation of 7.8 ± 9.2 ms, which was significantly different from the controls (p < 0.0001) but not from group 1. When compared to thallium stress testing, exercise QRS prolongation had a sensitivity of 93%, specificity of 71%, relative risk of 5, and positive predictive value of 86%. QRS duration measurement can improve the diagnostic accuracy of the exercise ECG stress test.
Noncardiac factors were better predictors of the effort tolerance of patients with coronary artery disease than parameters of left ventricular function at entry to an exercise program or after 6 months of training. A similar degree of adaptation to training was seen in all patients regardless of their degree of left ventricular systolic or diastolic dysfunction.
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