Angulated Views in the Sagittal Plane for Improved Accuracy of Cinecoronary Angiography

Lespérance, Jacques; Saltiel, J; Petitclerc, Robert; Bourassa, Martial G.

doi:10.2214/ajr.121.3.565

Cited by 82 publications

(13 citation statements)

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“…In these two clinical subsets the presence or absence of horizontal or downsloping ST-segment depression 1 mm, ST-segment elevation > 1 mm, or a slowly upsloping ST-segment depression > 2 mm at 0.08 seconds after the J point in any of 14 leads is highly predictive of multivessel disease when used in conjunction with treadmill work time. The predictive value of maximal treadmill testing using 14 ECG leads in men with nonspecific chest pain is less useful. The lower predictive value of a positive test occurs because this clinical subset has less severe coronary disease and a lower prevalence of disease than men with anginal symptoms.…”

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confidence: 99%

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“…SUMMARY Two hundred men with normal ECGs at rest had maximum treadmill tests using 14 14 leads and treadmill work time > 540 seconds had three-vessel disease.…”

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confidence: 99%

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The importance of clinical subsets in interpreting maximal treadmill exercise test results: the role of multiple-lead ECG systems.

Chaitman¹,

Waters²,

Bourassa³

et al. 1979

Circulation

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SUMMARY Two hundred men with normal ECGs at rest had maximum treadmill tests using 14 The diagnostic impact of maximal treadmill testing using 14 ECG leads is greatest in men with typical and probable angina. In these two clinical subsets the presence or absence of horizontal or downsloping ST-segment depression 1 mm, ST-segment elevation > 1 mm, or a slowly upsloping ST-segment depression > 2 mm at 0.08 seconds after the J point in any of 14 leads is highly predictive of multivessel disease when used in conjunction with treadmill work time. The predictive value of maximal treadmill testing using 14 ECG leads in men with nonspecific chest pain is less useful. The lower predictive value of a positive test occurs because this clinical subset has less severe coronary disease and a lower prevalence of disease than men with anginal symptoms. Recording a single lead such as CM, would suffice for the majority of patients in this subset using either horizontal or downsloping ST-segment depression 2 1 mm or ST-segment elevation > 1 mm as criteria for positivity.THE SENSITIVITY AND EFFICIENCY of maximal treadmill testing in men with angina pectoris can be increased by recording multiple ECG leads and combining the results with physiological data collected during exercise." 2 Little information is available on multiple-lead exercise testing in subsets of patients with a lower disease prevalence, such as asymptomatic patients, those with nonspecific chest pain, and women. Several investigators have reported decreased specificity of exercise test results in selected populations with a low disease prevalence.3-5 There is concern that the use of multiple ECG leads could increase the false positive rate in this type of population.

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The importance of clinical subsets in interpreting maximal treadmill exercise test results: the role of multiple-lead ECG systems.

Chaitman¹,

Waters²,

Bourassa³

et al. 1979

Circulation

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“…In studies of patients with stable angina, the annual mortality rate for one, two and three vessel disease has been reported at 2%, 8% and 11%, respectively.2' Left ventricular contraction abnormalities (found in 90% of the patients in our study) are associated with a higher annual mortality rate which varies depending upon the population.22' 23 Although survival statistics from other populations may not be directly applicable to the patients in this study, these data [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] suggest that a two year mortality rate of 15 to 23% might be expected for the 82% of patients in our study with multivessel disease.…”

Section: Discussion Angiographic Findingsmentioning

confidence: 80%

Prediction of multivessel disease after inferior myocardial infarction.

Chaitman¹,

Waters²,

Corbara³

et al. 1978

Circulation

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We correlated clinical parameters with angiographic findings in 108 men with a previous isolated inferior myocardial infarction, to determine if these parameters could predict accurately which patients had multivessel disease. Of 71 men in angina class 2-3, 42 had three vessel disease versus only seven of the 37 who were either asymptomatic or angina class 1 (P less than 0.001). Multivessel disease was present in 35 of the 36 who had anterior ST-T abnormalities at rest (P less than 0.001) and 16 of the 17 with cardiomegaly. Among men 55 years and older, the incidence of multivessel disease was 94% compared to 70% in men less than 55 (P less than 0.03). We conclude that functional angina class, age, and the presence of resting anterior ST and T abnormalities are highly predictive of associated left system disease in survivors of inferior infarction.

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“…6). Another good angiographic view to demonstrate the full extent of the proximal diagonal branches would be the anteroposterocranial projection [13,14]. This case also demonstrates the utility of obtaining adequate guiding views before the intervention.…”

Section: Discussionmentioning

confidence: 83%