Exercise-induced ST-segment changes in lead V1 identify the significantly narrowed coronary artery in patients with single-vessel disease correlation with thallium-201 scintigraphy and coronary arteriography data

• Published in: Journal of electrocardiology Vol. 32; no. 1; pp. 7 - 14
• Main Authors: MICHAELIDES, A. P, PSOMADAKI, Z. D, RICHTER, D. J, DILAVERIS, P. E, ANDRIKOPOULOS, G. K, KAKAIDIS, S, STEFANADIS, C, GIALAFOS, J. E, TOUTOUZAS, P. K
• Format: Journal Article
• Language: English
• Published: Orlando, FL Churchill Livingstone 1999; Philadelphia, PA Elsevier Science Ltd
• Subjects: Adult; Aged; Biological and medical sciences; Cardiac Catheterization; Cardiology. Vascular system; Coronary Angiography; Coronary Disease - diagnosis; Coronary Disease - physiopathology; Coronary heart disease; Electrocardiography; Exercise; Exercise Test; Female; Heart; Humans; Male; Medical sciences; Middle Aged; Myocardial Contraction; Observer Variation; Radionuclide Ventriculography; Thallium Radioisotopes; Radionuclide study; Human; Electrodiagnosis; Electrocardiography; ST interval; Cardiovascular disease; Medical imagery; Exercise tolerance test; Diagnosis; Scintigraphy; Coronary heart disease
• ISSN: 0022-0736; 1532-8430
• DOI: 10.1016/S0022-0736(99)90016-X

We investigated the correlation of exercise-induced ST-segment changes in lead V1, with the detection of the significantly narrowed vessel that induced ischemia during exercise in myocardial areas supplied by this vessel. We studied 198 patients who underwent exercise testing, thallium-201 scintigraphy, and coronary arteriography. The patients were divided into three groups. In group 1 (ST-segment elevation in lead V1), 84% had left anterior descending coronary artery disease (P<.001); in group 2 (ST-segment depression in lead V1), 76% had right coronary artery disease (P<.001); and in group 3 (no ST-segment changes in lead V1), there were no significant differences concerning the narrowed vessel. Thallium-201 scintigraphy data confirmed the existence of the reversible perfusion defect(s) in an area(s) of myocardium supplied by the respective coronary arteries (P<.001). Exercise-induced ST-segment elevation or depression in V1 may identify the obstructed vessel in patients with single-vessel disease and without prior myocardial infarction.