Dataset Information

The accuracy of the electrocardiogram during exercise stress test based on heart size.

ABSTRACT:

Background

Multiple studies have shown that the exercise electrocardiogram (ECG) is less accurate for predicting ischemia, especially in women, and there is additional evidence to suggest that heart size may affect its diagnostic accuracy.

Hypothesis

The purpose of this investigation was to assess the diagnostic accuracy of the exercise ECG based on heart size.

Methods

We evaluated 1,011 consecutive patients who were referred for an exercise nuclear stress test. Patients were divided into two groups: small heart size defined as left ventricular end diastolic volume (LVEDV) <65 mL (Group A) and normal heart size defined as LVEDV ?65 mL (Group B) and associations between ECG outcome (false positive vs. no false positive) and heart size (small vs. normal) were analyzed using the Chi square test for independence, with a Yates continuity correction. LVEDV calculations were performed via a computer-processing algorithm. SPECT myocardial perfusion imaging was used as the gold standard for the presence of coronary artery disease (CAD).

Results

Small heart size was found in 142 patients, 123 female and 19 male patients. There was a significant association between ECG outcome and heart size (?(2)?=?4.7, p?=?0.03), where smaller hearts were associated with a significantly greater number of false positives.

Conclusions

This study suggests a possible explanation for the poor diagnostic accuracy of exercise stress testing, especially in women, as the overwhelming majority of patients with small heart size were women.

SUBMITTER: Siegler JC

PROVIDER: S-EPMC3157363 | biostudies-literature | 2011

REPOSITORIES: biostudies-literature

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Publications

The accuracy of the electrocardiogram during exercise stress test based on heart size.

Siegler Jason C JC Rehman Shafiq S Bhumireddy Geetha P GP Abdula Raushan R Klem Igor I Brener Sorin J SJ Lee Leonard L Dunbar Christopher C CC Saul Barry B Sacchi Terrence J TJ Heitner John F JF

PloS one 20110817 8

<h4>Background</h4>Multiple studies have shown that the exercise electrocardiogram (ECG) is less accurate for predicting ischemia, especially in women, and there is additional evidence to suggest that heart size may affect its diagnostic accuracy.<h4>Hypothesis</h4>The purpose of this investigation was to assess the diagnostic accuracy of the exercise ECG based on heart size.<h4>Methods</h4>We evaluated 1,011 consecutive patients who were referred for an exercise nuclear stress test. Patients we ...[more]

PMID: 21857990

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Project description:INTRODUCTION:Patients with chronic heart failure (CHF) can benefit from exercise rehabilitation (ER) with significant improvements in exercise capacity, quality of life and reduction in hospitalisations. Despite its reported benefits, only a small number of patients with CHF attend ER due to poor adherence, and improper exercise may even lead to adverse events. Remote ECG monitoring system (REMS) has the potential to overcome these obstacles. We hypothesise that home-based cardiac ER using REMS in CHF patients is effective compared with conventional ER without monitoring. METHODS AND ANALYSIS:This study is a prospective, randomised, parallel controlled clinical trial designed to evaluate the effectiveness of home-based phase-II ER with REMS in the treatment of CHF with a target enrolment of 120 patients (left ventricular ejection fraction <50%, New York Heart Association (NYHA) classes I to III). Patients are randomised to either REMS rehabilitation group or conventional rehabilitation group in a 1:1 ratio. All patients start an exercise training in a supervised setting and then transition to a home-based regimen. The supervised training phase consists of 12 supervised training sessions, three sessions per week for 4 weeks. During the home exercise phase, patients exercise five times per week for 8 weeks. In the REMS group, patients wear monitors during exercise to ensure that exercise intensity is within the set ranges. REMS will also detect risky arrhythmia and alert the patients and their doctors on time. The training intensity is not monitored in the conventional rehabilitation group. The primary outcome is exercise capacity improvement measured by peak oxygen uptake (VO2 peak) (baseline vs 3 m). Secondary outcomes include 6-min walk test, NYHA classes, echocardiographic parameters, cardiac biomarkers, major adverse cardiovascular events, quality of life, psychological well-being and patients' adherence to the rehabilitation programme. ETHICS AND DISSEMINATION:This study was approved by Ethics Committee of China-Japan Friendship Hospital for Clinical Research (No. 2018-55 K39). The results of this study will be disseminated via peer-reviewed publications and presentations at conferences. TRIAL REGISTRATION NUMBER:ChiCTR-RNR-17012446; Pre-results.

Dataset Information

The accuracy of the electrocardiogram during exercise stress test based on heart size.

Background

Hypothesis

Methods

Results

Conclusions

Publications

The accuracy of the electrocardiogram during exercise stress test based on heart size.

Similar Datasets

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