Exercise induced ST segment elevation in aVR more than 2 mm  to differentiate between left main and three vessel disease in  patients with Duke score

Hussain Abbase Haider, Ala

	Exercise induced ST segment elevation in aVR more than 2 mm to differentiate between left main and three vessel disease in patients with Duke score
Medical Journal of Babylon
Article 1, Volume 7, Issue 3, 2010, Pages 322-330
Author
Ala Hussain Abbase Haider
Abstract
Back ground : This study evaluated the ability of exercise induced ST segment elevation in aVR in patients with Duke treadmill score £ -11 to predict left main stem disease and three vessel disease and to investigate the ability of ST segment elevation in aVR more than 2 mm to differentiate between left main stem and three vessel disease. Methods :66 patients with Duke score £ -11 were divided into three groups. group 1 included 16 patients with no ST elevation in aVR, group 2 included 21 patients with ST elevation less than 2 mm and group 3 included 29 patients with ST elevation more than 2 mm, coronary angiography was done and results were correlated with ST elevation in aVR Results : 70% of patients with ST segment elevation in aVR had either left main stem or 3 vessel disease. Exercise induced ST elevation in aVR had sensitivity of 95% and specificity of 32% in predicting left main disease, while exercise induced ST elevation in aVR more than 2 mm had sensitivity of 89% and specificity 74% in predicting left main disease. Conclusion : Eercise induced ST segment elevation in aVR in patients with Duke score £-11 is sensitive but not specific for both left main and three vessel disease while ST segment elevation in aVR of more than 2 mm is both sensitive and specific for left main but not for three vessel disease

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