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- Title
Accuracy of Exercise-Induced Left Axis QRS Deviation as a Specific Marker of Left Anterior Descending Coronary Artery Disease.
- Authors
Shiran, Avinoam; Halon, David A.; Merdler, Amnon; Makhoul, Nabeel; Khader, Nader; Ben-David, Joseph; Lewis, Basil S.
- Abstract
In this prospective study, we examined the diagnostic accuracy of exercise-induced left QRS axis deviation as a marker of LAD coronary artery stenosis. The mean frontal QRS axis of 66 consecutive patients with chest pain and exercise-induced ST segment depression referred for diagnostic coronary angiography was analyzed and related to the angiographic findings. An exercise-induced leftward QRS axis deviation was found in 9/40 patients with and 0/26 patients without obstructive (≥70%) LAD disease (sensitivity 23%, specificity 100%, p = 0.025). In 7 of the 9 patients with left axis deviation, the lesion was proximal to and in 2 in the region of the first septal perforator. Inclusion of patients with 0° exercise-induced QRS axis deviation provided a more sensitive but less specific marker of LAD disease [sensitivity 53% (21/40), specificity 81% (21/26), p = 0.015]. The findings were similar in patients with single and with multivessel coronary artery disease. Grouping all patients in the present prospective and two previous retrospective studies (n = 165), the sensitivity was 29% and specificity 100% (p < 0.0001). Exercise-induced left QRS axis deviation was a highly specific marker of LAD coronary artery stenosis.
- Subjects
ARTERIAL stenosis; CORONARY artery stenosis; EXERCISE tests; CHEST pain; ANGIOGRAPHY; CORONARY arterial radiography; PATIENTS
- Publication
Cardiology, 1998, Vol 89, Issue 4, p297
- ISSN
0008-6312
- Publication type
Article
- DOI
10.1159/000006802