CORRELAZIONI TRA ANGIOCARDIOGRAFIA E LE VARIAZIONI DI VOLTAGGIO DELL'ONDA R DURANTE SFORZO IN SOGGETTI CON CARDIOPATIA ISCHEMICA

The authors studied correlations between angiocardiography and changes of R wave amplitude ΔR) during effort in 113 patients. Coronarographic evidence showed 69 patients had stenosis ≥70% of at least one major coronary vessel and 44 patients had no significant lesions. ΔR values greater or equal than 0 were considered pathological. ΔR appeared ≥0 in 8 of 14 patients (57%) with single stenosis and in 4 patients (28%) with abnormal wall motion (AWM). ΔR increased or was unchanged in 26 of 31 patients (84%) with double stenoses, 25 of which (81%) had AWM. ΔR was ≥ 0 in 22 of 24 (92%) with triple stenoses. In subjects with mild coronary artery disease (CAD) the R wave was increased or unchanged in 47% (19/44). Pathological changes of the R wave are highly frequent in CAD patients, especially in those with severe impairment. These changes, however, are not specific or constant because they also appeared frequently in subjects with normal coronary vessels, and moreover, the R wave may decrease in CAD patients with severe impairment as well. The authors consider that evidence of ΔR values ≥0 may not be considered as a sign of CAD, but it must be evaluated with the other data showed by ergometric tests.