Exercise Body Surface Potential Mapping in Single and Multiple Coronary Artery Disease: Discussion (Part 2)
Certainly, the epidemiologic data from two recent studies of large patient populations have shown that the degree of exercise ST deviation, as measured from 12- and 15-lead electrocardiograms is a very strong and independent predictor of future coronary death and other clinical cardiac endpoints. A corollary of this reasoning is that CAD patients who fatigue on exercise in the absence of angina and who have, on average, the same degree of peak ST integral decrease as angina-limited single vessel CAD patients and normal subjects exercised to the same peak heart rate, may be viewed as having effective medical therapy and a relatively positive prognosis, as opposed to having nondiagnostic stress tests. Buy Asthma Inhalers Online
Another implication is that exercise stress is required to optimize the quantitative discriminating ability of ST integral BSPM. Resting negative ST integrals (Table 1) and the sum ST integral decrease between rest and 5 min recovery (Table 2) did not discriminate among patients with single- and multiple-vessel CAD. Stress also was important in the relationship between the sum ST integral decrease and the angiographic scores; correlations only were high with peak ST ischemia and not at 5 min recovery (Table 3).