Diagnostic value of the ratio of recovery systolic blood pressure to peak exercise systolic blood pressure for the detection of coronary artery disease

D. Acanfora, L. De Caprio, S. Cuomo, M. Papa, N. Ferrara, D. Leosco, P. Abete, F. Rengo

Research output: Contribution to journalArticle

Abstract

It has been previously reported that at treadmill exercise testing an abnormal ratio of recovery systeolic blood presure (SBP) to peak exercise SBP is more sensitive than exercise-induced angina or ST segment depression for diagnosing coronary artery disease (CAD). To investigate whether the SBP ratio keeps its diagnostic value during upright bicycle exercise, we evaluated the ratio of postexercise SBP to peak SBP in 73 patients with angiographically documented CAD and in 48 patients with normal coronary arteries (OV group) undergoing maximal stress testing on a bicycle ergometer. Three minutes after exercise ended, SBP ratio was significantly higher in the CAD than in the OV group (0.79 ± 0.1 vs 0.71 ± 0.08; p <.001). Setting the upper normal limits of the recovery SBP ratio at 2 SDs from the mean for the OV group (SBP ratio = 0.98 and 0.88 at 1 and 3 min after exercise, respectively), with an increase or no change in SBP ratio at between 1 and 3 min of recovery considered an abnormal response, the sensitivity of SBP ratio was 30%, the specificity was 83%, and the accuracy was 51%. The respective values for ST depression were 81% (p <.001 vs SBP ratio), 48% (p <.001 vs SBP ratio), and 67% (p <.01 vs SBP ratio). Thus, for bicycle ergometer exercise testing, ST segment depression seems to be more accurate than SBP ratio in diagnosing CAD.

Original languageEnglish
Pages (from-to)1306-1310
Number of pages5
JournalCirculation
Volume77
Issue number6
Publication statusPublished - 1988

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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    Acanfora, D., De Caprio, L., Cuomo, S., Papa, M., Ferrara, N., Leosco, D., Abete, P., & Rengo, F. (1988). Diagnostic value of the ratio of recovery systolic blood pressure to peak exercise systolic blood pressure for the detection of coronary artery disease. Circulation, 77(6), 1306-1310.