Exercise Body Surface Potential Mapping in Single and Multiple Coronary Artery Disease: Methods (1)

In: Coronary Artery Disease

9 Dec 2012

Subjects
The patient group consisted of 51 unselected adults with CAD referred to the Cardiac Investigation Service of the Victoria General Hospital (Table 1 and 2). The inclusion criteria were a clinical history of exercise-associated visceral chest pain compatible with angina, willingness to perform an exercise test according to the study protocol and angiographically demonstrated CAD. Excluded were patients with bundle branch block, artificial pacemakers or any physical disability that precluded exercise tolerance testing. All study subjects had coronary arteriography within 24 h of exercise testing.
Based on their exercise test endpoints and coronary angiographic anatomy and blinded from all other study data, the CAD patients were divided into four groups. asthma inhalers
Ail CAD patients in groups 1 to 3 reached an exercise endpoint of clinical ischemia (angina, n = 35, ST depression in lead Vs, n = 1) (Table 2). Group 1 was composed of 23 subjects with critical (^70 percent luminal narrowing) stenosis isolated to a single coronary artery (Table 1). Fourteen group 1 patients had isolated left anterior descending CAD; four patients had isolated right CAD; and five patients had isolated circumflex CAD (Table 1). Group 2 was composed of eight patients with critical two-vessel CAD (Table 1). Group 3 was composed of five patients with critical three-vessel CAD (Table 1).

Table 1—Clinical, Angiographic and Besting Body Surface Map Data of 51 Study Subjects with Coronary Artery Disease

Patient Age (yr), Sex LV Wall Motion Abnormality Percent Luminal Narrowing GensiniScore 2 Negative ST (fiV-s)
LAD RCA CX
Group 1
1 73, M 0 99 0 0 42 -1,540
2 32, M + 75 0 0 10 – 870
3 78, F + 90 0 0 20 – 520
4 41, F + 99 0 0 24 – 617
5 60,M + 100 0 0 76 -2,698
6 54,M 0 100 0 0 89 -1,703
7 61, F + 99 0 0 40 -1,341
8 47,F 0 90 0 0 13 -1,943
9 36, M + 99 0 0 40 -1,065
10 60, M 0 99 0 0 24 -1,077
11 55, M 0 99 0 0 24 – 955
12 57, M + 90 0 0 17 – 959
13 62, M + 99 0 0 26 – 596
14 59,M + 100 0 0 36 -1,901
15 58,M + 0 100 0 45 -4,279
16 35,M 0 0 99 0 14 -1,781
17 54,F + 0 100 0 28 -3,324
18 54,M + 0 99 0 17 -1,835
19 41,M 0 0 0 100 28 -1,163
20 32, F 0 0 0 90 8 -1,599
21 63,F 0 0 0 99 16 -2,818
22 63,M + 0 0 75 6 – 465
23 36,M 0 0 0 99 42 -1,321
Mean±SD 53 30 -1,581
13 20 949
Group 2
24 59, M 0 100 90 0 90 -1,622
25 64,F + 99 100 0 67 -1,500
26 36,M + 90 75 0 29 -2,595
27 58,M + 90 0 80 40 -2,948
28 56,M + 90 0 100 50 -1,468
29 67,F 0 70 0 100 104 -1,244
30 64, M + 100 0 99 56 -1,009
31 44,M + 100 0 100 109 – 326
Mean±SD 56 68* -1,589
11 30 839
Group 3
32 59,M + 100 100 75 58 – 902
33 53,M + 75 100 90 52 -2,356
34 48,M 0 75 90 75 27 -1,431
35 45,M + 75 100 100 74 – 949
36 60,F + 99 99 99 67 -1,097
Mean ± SD 53 56t -1,347
7 18 601
Group 4
37 44,M + 100 0 0 31 – 510
38 62,F + 0 100 0 16 -2,760
39 62, F + 75 0 0 10 – 983
40 45,M + 99 50 90 64 -1,734
41 70,M 0 40 40 0 1 – 813
42 60,F 0 90 0 0 20 -1,064
43 47, M 0 0 75 75 14 -1,660
44 54,M 0 90 0 0 24 -1,635
45 44,M 0 0 90 100 36 -1,211
46 63,M + 70 0 70 14 -1,868
47 51,M 0 0 60 90 12 -1,748
48 48,M 0 75 0 0 6 -1,357
49 37, M 0 95 0 0 40 -1,519
50 48,M + 60 0 0 8 -1,097
51 55,M + 90 100 0 50 -1,326
Mean ± SD 53 23 -1,419
9 18 534

Table 2—Exercise Test Data of 51 Study Subjects with CAD

Thallium’ 1 ST Decrease (^jlV-s)
Clinical Peak Reversible Cessation Recovery 5
Patient Endpoint* Heart Rate Defect Score -Rest -Rest
Group 1
1 CP 101 + 10 – 3,784 – 1,695
2 98 + 6 – 3,616 – 469
3 94 + 10 – 727 – 514
4 112 0 0 – 2,511 -3,499
5 ECG 98 + 13 – 9,043 -6,202
6 CP 101 + 10 – 4,290 -2,707
7 116 + 1 – 7,235 -5,440
8 105 + 8 – 4,114 -3,112
9 114 + 1 – 3,308 – 1,291
10 75 + 2 – 6,394 -4,818
11 81 + 8 – 1.297 -1,049
12 88 + 2 – 1,682 – 968
13 111 0 0 – 2,902 -1,833
14 79 + ‘ 10 – 2,683 -2,486
15 81 0 0 – 5,252 – 869
16 96 + 6 – 2,581 – 1,241
17 98 + 11 – 3,776 -2,163
18 109 + 6 – 3.065 -2,746
19 96 + 3 – 1,590 – 422
20 129 + 1 – 3,351 -1,648
21 85 + 2 – 2,935 -2,498
22 99 0 0 – 731 -1,292
23 90 + 3 – 2,418 -.352
Mean±SD 98 5 – 3,447 — 2,144t
13 4 2,011 1,607
Group 2
24 103 0 0 – 9,893 -5,044
25 92 + 13 – 6,537 -3,423
26 104 0 0 – 5,190 -2,590
27 104 0 0 – 2,996 -2,039
28 110 0 0 – 4,705 – 712
29 84 0 0 – 2,715 -3,943
30 120 + 9 – 6,207 -3,246
31 91 + 8 – 7,355 -1,537
Mean ± SD 101 4 – 5,700* -2.817*
12 5 2,.353 1,389
Group 3
32 93 + 9 – 8,386 -2,196
33 98 + 8 – 7,364 -4,548
34 92 0 0 – 5,159 -2,264
35 108 + 12 -11,214 -3,478
36 77 + 6 – 4,288 -2,332
Mean ± SD 94 7 – 7,282t – 2,964§
11 4 2,746 1,031
Group 4
37 Fatigue 89 + 3 – 1,928 1,737
38 102 + 1 – 2,917 3,232
39 80 0 0 – 3,939 -1,649
40 92 0 0 – 3,117 -1.685
41 81 + 6 – 598 -2,1.58
42 103 0 0 – 4,050 -4,282
43 93 + 2 – 4,928 -2,912
44 103 0 0 – 3,009 -3,299
45 116 + 2 – 2,851 -1,946
46 96 + 6 – 4,575 -5,327
47 102 + 2 – 5,371 -2,402
48 85 + 3 – 2,823 -1,617
49 88 0 0 – 1,215 – 76
50 158 0 0 – 2,138 -1,905
51 100 + 6 – 3,814 – 599
Mean ± SD 100 2 – 3,152 -2,322||
19 2 1,337 1,338

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