EXERCISE ELECTROCARDIOGRAM AND SINGLE-VESSEL CORONARY-ARTERY DISEASE

The aim of this study was to assess the efficiency of exercise tests i n identifying ischaemia in the territories supplied by the three main coronary arteries. We prospectively analysed 578 patients with single vessel coronary disease (>50% stenosis in one vessel and completely no rmal other vessels). Patients with single vessel coronary artery disea se were divided into three groups: patients with significant left ante rior coronary artery disease (group 1, n=234); patients with significa nt right coronary artery disease (group 2, n=201); patients with signi ficant left circumflex disease (group 3, n=143). Our study, which is t he largest prospective study of patients with angiographically documen ted single vessel coronary artery disease, suggests that the exercise electrocardiogram is a poor predictor of circumflex coronary artery is chaemia. In addition, the site of ST depression identified from the el ectrocardiogram was a poor predictor of the site of myocardial ischaem ia. No single lead could distinguish between the three groups and the location of coronary stenosis could not be predicted by location of ST depression.