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RISS 인기검색어
- 검색키워드
- 저자 : 김석연(Seog Yeon Kim) (검색결과 2 건)
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최락경(Rak Kyeong Choi),이무용(Moo Yong Rhee),전원호(Won Ho Jeon),김인수(In Su Kim),김석연(Seog Yeon Kim),전용덕(Yong Deog Jeon),이홍순(Hong Soon Lee),유수웅(Soo Woong Yoo),이학중(Hak Choong Lee) 대한내과학회 1995 대한내과학회지 Vol.49 No.5
N/A Objectives: The exercise test is commonly used in conjunction with baseline clinical information to estimate the likelihood that a patient has significant coronary diseases. The purpose of this study was to determine if patterns of ST depression or elevation during exercise testing provide reliable information about the location of an underlying coronary lesion. Methods: We reviewed 49patients out of 137patients who performed treadmill test and coronary angiography at National Medical Center from January, 1984 through August, 1993. All the patients underwent modified Bruce protocol treadmill exercise test and coronary angiography. Exercise ST changes were classified as depression or elevation by lead groups involved(V1-V3, V4-6, I AVL, II III AVF), Coronary angiography was done in several oblique projections and results were reviewed by at least two senior angiographers. Results: 1) There were significant stenosis in coronary angiography in 22cases(70.9%) among positive 31cases, 0cases(0%) among borderline positive 4cases, 5cases(10.2%) among negative 49cases. 11cases(47.8%) among nondiagnostic 23cases, and 3cases(25%) among pseudonormalization 12cases in exercise treadmill tests. 2) The sensitivity of treadmill exercise electrocardiography was 61.2%, and specificity was 81.8%. The sensitivity of each coronary artery diseases was 6l.7% in Left anterior descending artery disease, 66.6% in Right coronary artery disease, 38.5% in Left circumflex artery disease, 100% in 2-vessel disease, and 100% in 3-vessel disease. 3) ST depression was not useful in predicting the site of coronary artery narrowing. In contrast, ST elevation was correlated with coronary artery disease. 4) ST depression was most often seen in leads V4-V6 and leads II III AVF without correlation between the diseased coronary artery and the leads in which ST depression occurred. Conclusion: The exercise treadmill induced depression of the ST segment is an significant sign for predicting the presence of coronary artery disease and for the decision to perform coronary angiography. But, site of ST depression during exercise is not a good predictor of anatomic site of coronary artery disease. The other noninvasive test and coronary angiography may be necessary to nondiagnostic group which revealed insufficient exercise load or target heart rate during exercise test because the presence of coronary artery disease can't be ruled out.
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