Correlation of Treadmill Exercise Test and Coronary Angiogram in Coronary Artery Disease

Yoon, Yong Kwang; Lee, Woong Ku; Cho, Seoung Yun; Shim, Won Heum; Chung, Nam Sik; Chung, Ick Mo

Abstract

The exercise ECG gives a valuable indirect evidence of insufficient myocardial perfusion during stress, but it has been impossible with ECG data alone to localize the site or sites of partial or complete arterial occlusion. The coronary angiography has proved to be valvuable as a technique for identifying anatomical lesions. However, arteriography alone dose not provide evaluation of the underlying myocardium. The two tests are complementary, one supplying indirect physiologic data and the other providing anatomical licalization of obstruction. The author reviewd 58 patients out of 86 patients who performed treadmill test and coronary angiography at the cardiac laboratory of Yonsei University Severance Hospital from January, 1981 through December, 1983. The following results were obtained. 1) Among the 58 patients in this study, 33 had negative exercise test and 25 had positive test. 2) Among the 14 patients who ended exercise test due to chest pain,2patients had negative exercise test. Coronary angiography on all the 14 patients showed significalt coronary artery stenosis. 3) With this multigraded treadmill test, the sensitivity was 68.8% and spedccificity was 88.7%. 4) The appreance of ischemic change during the early stage of exercise, the deeper ST segment depression and the downsloping ST segment have the higest specificity as indicators of coronary artery disease. 5) Four patients showed ST segment elevation in the exercise ECG, and their coronary angiogram showed 1-vessel disease in 1 patientts, 2-vessel dosease in 2 and 3-vessel disease in 3. All of them had multiple stenosis or complete obstruction of the left anterior descending artery on coronary angiogram and ventricualar dyskinesia on the left ventriculogram.