Relationships between exercise ECG and angiocardiographic indices of coronary insufficiency and myocardial fibrosis in coronary heart disease

Abstract

Patients with coronary heart disease were examined with exercise ECG and angiocardiography. Maximum work capacity expressed as a percentage of the predicted normal exercise tolerance (Wmax%) was significantly associated with the angiocardiographic score of the myocardial mass subserved by obstructed coronary arteries (MCOS). Variables related to myocardial fibrosis (MF) such as post infarction ECG signs, the left ventricular wall motion score (LVMS) and the ejection fraction of the left ventricle (LVEF) correlated significantly as did variables related to reversible myocardial ischaemia or coronary insufficiency (CI), such as ST depression during exercise (STdepr), ST/W and ST/HR indices, effort angina (EA/W) index, the extent of collaterals (CollS), and 'MCOS-LVMS'. MF variables correlated weakly with CI variables. Wmax% covariated with the variables related to both CI and MF, and most closely with MCOS. Discrepancies between results of exercise ECG and angiocardiography have to some extent been overcome by comparing appropriate parameters.

Effects of digitalis, anti‐anginal drugs and arterial hypertension on the relationships between exercise ECG and angiocardiographic variables and on the diagnostic accuracy of exercise ECG in patients with coronary heart disease

“…The variables obtained from the exercise ECG test and the angiocardiographic examination of this group of 153 patients showed wide variation (see Backman et al, 1993). After exclusion of patients with heart failure and significant valvular heart disease, there remained 153 patients.…”

“…However, the multivariate statistical analysis chosen had the advantage of enabling comparison with the previous analysis of the same patient group (Backman et al, 1993) and prediction of individual values of the exercise ECG variables provided the regressor variables are known. However, the multivariate statistical analysis chosen had the advantage of enabling comparison with the previous analysis of the same patient group (Backman et al, 1993) and prediction of individual values of the exercise ECG variables provided the regressor variables are known.…”

“…The methods used for the bicycle ergometer exercise ECG test have been described previously (Backman et a[., 1993). They include the evaluation of the maximum work capacity (W,,,), the prediction of the normal maximum work capacity ( W m a x~) , the evaluation of relative work capacity (Wmaxyo = l~x w m a x / w m a x N ) , an indirect measure of relative work capacity in these patients, i.e.…”

Comparison of some criteria for diagnosing a myocardial infarction after aorto‐coronary bypass grafting (CABG)

“…The examination also included recording of a standard 12-lead electrocardiogram at rest. Angiocardiographic methods were used to estimate several variables, as described previously (Backman et al, 1986a(Backman et al, , 1986b(Backman et al, , 1993. The left ventricular wall motion score (LVMS) is the sum of the wall motion points (WMP) from seven segments of the left ventricular wall obtained by two-plane ventriculography.…”

“…This separation into MI (ECGsp) and MI (ECGnonsp) is a slight modification of the version described by Bjurulf et al (1967). The MI (ECG) criteria were used instead of more sophisticated ones because, in previous studies, it was found to correlate significantly with left ventricular wall motion score (LVMS) and the left ventricular ejection fraction (LVEF) (Backman et al, 1986a(Backman et al, , 1986b(Backman et al, , 1993 and myocardial fibrosis at autopsy (Bjurulf et al, 1967). Q-wave infarction, MI (Q-wave), was diagnosed according to the Minnesota code criteria 1:l-3.…”