Exercise-induced ST-segment changes in lead V-1 identify the significantlynarrowed coronary artery in patients with single-vessel disease - Correlation with thallium-201 scintigraphy and coronary arteriography data

We investigated the correlation of exercise-induced ST-segment changes in l ead V-1, with the detection of the significantly narrowed vessel that induc ed ischemia during exercise in myocardial areas supplied by this vessel. We studied 198 patients who underwent exercise testing, thallium-201 scintigr aphy, and coronary arteriography. The patients were divided into three grou ps. In group 1 (ST-segment elevation in lead V-1), 84% had left anterior de scending coronary artery disease (P < .001); in group 2 (ST-segment depress ion in lead V-1), 76% had right coronary artery disease (P < .001); and in group 3 (no ST-segment changes in lead V-1), there were no significant diff erences concerning the narrowed vessel. Thallium-201 scintigraphy data conf irmed the existence of the reversible perfusion defect(s) in an area(s) of myocardium supplied by the respective coronary arteries (P < .001). Exercis e-induced ST-segment elevation or depresssion in V-1 may identify the obstr ucted vessel in patients with single-vessel disease and without prior myoca rdial infarction.