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Prognostic role of magnetic-resonance imaging in patients with nonischemic ventricular arrhythmias

Authors: Berdibekov B.Sh., Aleksandrova S.A., Gromova O.I., Meladze M.G., Golukhova E.Z.

Company: 1 Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation
2 Davydovskiy Municipal Сlinical Hospital # 23, Moscow, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2022-16-2-226-235

For citation: Tret’yakova M.M., Manchurov V.N., Skrypnik D.V., Vasilieva E.Yu., Shpektor A.V. Electrocardiographic features of left main coronary artery stenosis in patients with multivessel coronary artery disease who underwent the exercise tolerance testing. Creative Cardiology. 2022; 16 (2): 226–35 (in Russ.). DOI: 10.24022/1997-3187-2022-16-2-226-235

Received / Accepted:  26.03.2022 / 24.06.2022

Keywords: exercise testing electrocardiogram left main coronary artery

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Abstract

Objective. To explore the electrocardiographic features of left main coronary artery stenosis (LMCAS) in patients with multivessel coronary artery disease who underwent the exercise tolerance testing (EST).

Material and methods. We enrolled 78 patients with suspected myocardial ischemia who underwent the standard Bruce EST followed by coronary angiography. Patients were included into the study if they had adequately performed and interpretable EST and multivessel coronary artery disease revealed by coronary angiography. According to the coronary angiography results, patients were divided into two groups: with (n =36) and without (n = 42) LMCAS. We compared the Duke index and ST segment deviations during EST between two groups.

Results. The Duke index was significantly lower in patients with LMCAS: –12.2 vs. –8.5, respectively (р = 0.006). The frequency of ST segment elevation in lead aVR was significantly higher in patients with LMCAS: 55 vs. 19%, respectively (р = 0.004). Six or more leads with ST segment depression on peak exercise observed significantly more often in patients with LMCAS: 31 vs. 2,5% (р = 0.001). The combined sign, including Duke index ≤–11 in combination with ST segment elevation ≥ 1 mm in lead aVR and/or 6 or more leads with ST segment depression was found in the group with lesions of the LMCAS and was not observed in the control group (р = 0.001; specificity 97.5%).

Conclusion. A combined sign including low Duke index in combination with ST segment elevation in lead aVR and/or 6 or more leads with ST segment depression may serve as a highly specific predictor of LMCAS in patients with multivessel coronary artery disease.

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About Authors

  • Mariya M. Tret’yakova, Postgraduate, Cardiologist; ORCID
  • Vladimir N. Manchurov, Cand. Med. Sci., Assistant Professor, Endovascular Surgeon; ORCID
  • Dmitriy V. Skrypnik, Dr. Med. Sci., Chief of Chair, Head of Department; ORCID
  • Elena Yu. Vasilieva, Dr. Med. Sci., Professor, Head of Laboratory; ORCID
  • Aleksander V. Shpektor, Dr. Med. Sci., Professor, Corresponding Member of RAS, Honorary Chief of Chair; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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