Escore eletrocardiográfico para avaliação de isquemia miocárdica: aplicação em testes ergométricos sequenciais para avaliação do fenômeno do aquecimento / Electrocardiographic score for myocardial ischemia evaluation: application in sequential exercise tests for warm-up phenomenon evaluation

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

The time to 1.0mm ST-segment depression (T-1.0mm), adopted to document the warm-up phenomenon, an expression of the ischemic preconditioning (IPC), during sequential exercise tests is considered reliable and reproductible, although with several limitations. The main goal of this study was to apply an electrocardiographic ischemic myocardium score to sequential exercise tests, comparing with the standard T-1.0mm. We evaluated 61 patients, mean age 62,2+7,5 years-old, 86.9% male, with type 2 diabetes mellitus and multivessel coronary disease. We analyzed 151 exercise tests, being 116 tests from patients who fulfilled the two phases of the study. The first phase enrolled the patients for two sequential exercise tests to document the IPC and the second phase, after 1 week, two additional sequential exercise tests were performed under repaglinide treatment. We observed a perfect concordance inter and intraobserver (Kendall Tau-b=0.96, p<0.0001; Kendall Tau-b=0,98, p<0,0001, respectively). The sensibility, specificity, positive predictive value and negative predictive value were also determined: 72.41%, 89.29%, 75.8%, 87.5% and 81%, respectively. In conclusion, the electrocardiographic ischemic score is a consistent and reproductible tool to document the warm-up phenomenon, representing a reliable alternative to the T-1.0mm.

ASSUNTO(S)

ischemic preconditioning myocardial ischemia electrocardiography eletrocardiografia isquemia miocárdica exercise test teste de esforço coronary disease precondicionamento isquêmico doenças das coronárias

ACESSO AO ARTIGO

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