Loeb HS, Friedman NC. Normalization of abnormal T-waves during stress testing does not identify patients with reversible perfusion defects.
Clin Cardiol 2007;
30:403-7. [PMID:
17680621 PMCID:
PMC6653613 DOI:
10.1002/clc.20111]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE
To determine if T-wave normalization during exercise or dobutamine stress testing identified patients with myocardial ischemia as indicated by reversible perfusion defects.
METHODS
Exercise or dobutamine stress tests with perfusion scintigraphy were performed in 1,173 patients with abnormal T-waves on their baseline electrocardiograms. The results of perfusion scintigraphy were compared in patients with and without stress-induced T-wave normalization.
RESULTS
Only 33 of 270 patients with reversible perfusion defects (12.2%) had T-wave normalization during stress while 76.4% of 140 patients who had T-wave normalization during stress did not have a reversible perfusion defect. Results were similar for patients who did or did not reach 85% of their maximal predicted heart rate, for patients with and without Q-wave infarction on the baseline EKG and for patients who did or did not have ischemic ST-segment depression during stress.
CONCLUSIONS
T-wave normalization during stress testing has low sensitivity and poor positive predictive value for stress-induced reversible myocardial ischemia.
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