0
March 14, 1980, Vol 243, No. 10 >
ARTICLE | March 14, 1980

Automated and Nomographic Analysis of Exercise Tests FREE

Michael H. Sketch, MD; Syed M. Mohiuddin, MD; Chandra K. Nair, MD; Aryan N. Mooss, MD; Vincent Runco, MD
[+] Author Affiliations

Reprint requests to Creighton University School of Medicine, 601 N 30th St, Omaha, NE 68131 (Dr Sketch).


JAMA. 1980;243(10):1052-1055. doi:10.1001/jama.1980.03300360024018
Text Size: A A A
Published online
Article
References

A study was conducted to evaluate the validity and usefulness of a commercially available microprocessor for automated exercise ECG analysis and to develop a nomogram for estimating the severity of coronary artery disease. Results of visual analysis, automated analysis, and coronary arteriography were correlated for the 107 patients studied. Automated analysis was shown to be valid and useful. The ST integrals (area of ST depression) recorded after exercise were superior to those recorded during exercise because they manifested higher specificity and predictive value, even though their sensitivity was slightly lower. Using postexercise integrals, it was possible to differentiate mild and severe disease. From multipleregression analysis of ST integrals, duration of exercise, and the severity of coronary artery disease, a nomogram was derived to estimate severity of coronary artery disease.

(JAMA 243:1052-1055, 1980)

REFERENCES

1 +
Tonkon M, Miller R, DeMaria A, et al:  Multifactor evaluation of determinants of ischemic electrocardiographic response to maximal treadmill testing in coronary disease . Am J Cardiol 62:337-346, 1977;.
2 +
Ellestad M, Savitz S, Bergdall D, et al:  The false positive stress test: Multivariant analysis of 215 subjects with hemodynamic, angiographic and clinical data . Am J Cardiol 40:681-683, 1977;.
3 +
Berman J, Wynne J, Cohn P:  A multivariate approach for interpreting treadmill exercise tests in coronary artery disease . Circulation 58:505-511, 1978;.
4 +
Bruce R, Kusumi D, Hosmer D:  Maximum oxygen intake and nomographic assessment of functional aerobic impairment in cardiovascular disease . Am Heart J 85:546-562, 1973;.
5 +
Goldschlager N, Selzer A, Cohn K:  Treadmill stress tests as indicators of the presence and severity of coronary artery disease . Ann Intern Med 85:277-286, 1976;.
6 +
Blackburn H:  The exercise electrocardiogram: Differences in interpretation . Am J Cardiol 21:871-880, 1968;.
7 +
Bloomqvist G:  The Frank lead exercise electrocardiogram: A quantitative study based on averaging technique and digital computer analysis . Acta Med Scand , (suppl 440) , 1965;, pp 1-98.
8 +
Forlini FJ, Cohn K, Langston MF:  ST segment isolation and quantification as a means of improving diagnostic accuracy in treadmill stress testing . Am Heart J 90:431-438, 1975;.
9 +
McHenry PL, Stowe D, Lancaster MC:  Computer quantification of ST-segment response during maximal treadmill exercise . Circulation 38:691-701, 1968;.
10 +
Simmoons M:  Computer processing of exercise electrocardiograms , in von Bemmel JH, Willen JL (eds): Trends in Computer-Processed Electrocardiograms . Amsterdam, North-Holland Publishing Co, 1977;, pp 383-406.
11 +
Sheffield LT, Holt JH, Lester FM, et al:  On-line analysis of the exercise electrocardiogram . Circulation 11:933-41, 1969;.
12 +
Bruce RA, Hornsten TR:  Exercise stress testing in evaluation of patients with ischemic heart disease . Prog Cardiovasc Dis 11:371-390, 1969;.
13 +
Sheffield LT, Holt JH, Reeves TJ:  Exercise graded by heart rate in electrocardiographic testing for angina pectoris . Circulation 32:622-629, 1965;.
14 +
Bruce RA, Kasumi F, Hosmer D:  Maximal oxygen intake and nomographic assessment of functional aerobic impairment in cardiovascular disease . Am Heart J 85:546-562, 1973;.
15 +
Sketch MH:  Exercise tests: What to look for . Primary Cardiol 2:16-19, 1976;.
16 +
Sketch MH, Mohiuddin SM, Lynch JD, et al:  Significant sex differences in the correlation of electrocardiographic exercise testing and coronary arteriograms . Am J Cardiol 36:169-173, 1975;.
17 +
Zohman LR, Kattus AA:  Exercise testing in the diagnosis of coronary heart disease: A perspective . Am J Cardiol 40:243-250, 1977;.
18 +
Kasser I, Bruce R:  Comparative effects of aging and coronary artery heart disease on suomaximal and maximal exercise . Circulation 39:759-774, 1969;.
19 +
Sketch M, Nair C, Esterbrooks D, et al:  Reliability of single and multiple-lead electrocardiography during and after exercise . Chest 74:394-401, 1978;.
20 +
Bonoris PE, Greenberg PS, Christison GW, et al:  Evaluation of R wave amplitude changes versus ST-segment depression in stress testing . Circulation 57:904-910, 1978;.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Tonkon M, Miller R, DeMaria A, et al:  Multifactor evaluation of determinants of ischemic electrocardiographic response to maximal treadmill testing in coronary disease . Am J Cardiol 62:337-346, 1977;.
2 +
Ellestad M, Savitz S, Bergdall D, et al:  The false positive stress test: Multivariant analysis of 215 subjects with hemodynamic, angiographic and clinical data . Am J Cardiol 40:681-683, 1977;.
3 +
Berman J, Wynne J, Cohn P:  A multivariate approach for interpreting treadmill exercise tests in coronary artery disease . Circulation 58:505-511, 1978;.
4 +
Bruce R, Kusumi D, Hosmer D:  Maximum oxygen intake and nomographic assessment of functional aerobic impairment in cardiovascular disease . Am Heart J 85:546-562, 1973;.
5 +
Goldschlager N, Selzer A, Cohn K:  Treadmill stress tests as indicators of the presence and severity of coronary artery disease . Ann Intern Med 85:277-286, 1976;.
6 +
Blackburn H:  The exercise electrocardiogram: Differences in interpretation . Am J Cardiol 21:871-880, 1968;.
7 +
Bloomqvist G:  The Frank lead exercise electrocardiogram: A quantitative study based on averaging technique and digital computer analysis . Acta Med Scand , (suppl 440) , 1965;, pp 1-98.
8 +
Forlini FJ, Cohn K, Langston MF:  ST segment isolation and quantification as a means of improving diagnostic accuracy in treadmill stress testing . Am Heart J 90:431-438, 1975;.
9 +
McHenry PL, Stowe D, Lancaster MC:  Computer quantification of ST-segment response during maximal treadmill exercise . Circulation 38:691-701, 1968;.
10 +
Simmoons M:  Computer processing of exercise electrocardiograms , in von Bemmel JH, Willen JL (eds): Trends in Computer-Processed Electrocardiograms . Amsterdam, North-Holland Publishing Co, 1977;, pp 383-406.
11 +
Sheffield LT, Holt JH, Lester FM, et al:  On-line analysis of the exercise electrocardiogram . Circulation 11:933-41, 1969;.
12 +
Bruce RA, Hornsten TR:  Exercise stress testing in evaluation of patients with ischemic heart disease . Prog Cardiovasc Dis 11:371-390, 1969;.
13 +
Sheffield LT, Holt JH, Reeves TJ:  Exercise graded by heart rate in electrocardiographic testing for angina pectoris . Circulation 32:622-629, 1965;.
14 +
Bruce RA, Kasumi F, Hosmer D:  Maximal oxygen intake and nomographic assessment of functional aerobic impairment in cardiovascular disease . Am Heart J 85:546-562, 1973;.
15 +
Sketch MH:  Exercise tests: What to look for . Primary Cardiol 2:16-19, 1976;.
16 +
Sketch MH, Mohiuddin SM, Lynch JD, et al:  Significant sex differences in the correlation of electrocardiographic exercise testing and coronary arteriograms . Am J Cardiol 36:169-173, 1975;.
17 +
Zohman LR, Kattus AA:  Exercise testing in the diagnosis of coronary heart disease: A perspective . Am J Cardiol 40:243-250, 1977;.
18 +
Kasser I, Bruce R:  Comparative effects of aging and coronary artery heart disease on suomaximal and maximal exercise . Circulation 39:759-774, 1969;.
19 +
Sketch M, Nair C, Esterbrooks D, et al:  Reliability of single and multiple-lead electrocardiography during and after exercise . Chest 74:394-401, 1978;.
20 +
Bonoris PE, Greenberg PS, Christison GW, et al:  Evaluation of R wave amplitude changes versus ST-segment depression in stress testing . Circulation 57:904-910, 1978;.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems