Vol 15, No 2 (2008)
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Published online: 2008-02-21
Principles of simple heart rate adjustment of ST segment depression during exercise electrocardiography
Cardiol J 2008;15(2):194-200.
Abstract
Compared with standard test criteria, simple heart rate (HR) adjustment of ST depression
during exercise electrocardiography can improve the identification and assessment of underlying
coronary artery disease. Since heart rate during exercise drives progressive ST segment
depression in the presence of coronary obstruction that limits flow reserve, the ST/HR index
controls for the increasing metabolic severity of ischemia that accompanies exercise. Improvement
of exercise test sensitivity with the ST/HR index results from reclassification of otherwise
"equivocal" and even "negative" test responses, including increased identification of one and
two-vessel disease in men and in women. In addition, in population studies of low and
moderate risk subjects, the ST/HR index can increase the prognostic value of the exercise
electrocardiogram for prediction of cardiac risk and mortality. (Cardiol J 2008; 15: 194-200)
Keywords: exerciseexercise testingexercise electrocardiogram