Impegno atriale sinistro durante test da sforzo: un nuovo segno elettrocardiografico di ischemia transitoria.

Translated title of the contribution: Left atrial enlargement during the exercise test: a new electrocardiographic sign of transitory ischemia

A. Margonato, C. Canciani, D. Cianflone, C. Nitti, G. Vicedomini, M. Carlino, S. L. Chierchia

Research output: Contribution to journalArticlepeer-review

Abstract

In patients with coronary artery disease, electrocardiographic signs of left atrial enlargement (LAE-negative P wave deflection greater than or equal to 1 mm2 in lead V1) are associated with increased left ventricular end diastolic pressure (LVEDP). We investigated the possibility that transient LAE could represent an additional criterion for diagnosing myocardial ischemia during exercise testing (EST). We studied 48 consecutive patients with chronic stable angina, positive EST and 201 Tl scintigraphy, and angiographically proven CAD; 200 other consecutive patients with atypical chest pain and normal stress/rest 201 Tl scintigraphy served as controls. During EST, transient LAE developed in 34/48 patients with CAD but in only 1/200 controls (p less than 0.001). When present, LAE preceded ST changes (6.1 +/- 1 min vs 8.2 +/- 2 min) and recovered earlier (4.7 +/- 4 min vs 5.8 +/- 3 min). The prevalence of 2-3 vessel CAD was significantly higher in patients with EST-induced LAE (54% vs 34%, p less than 0.05). In conclusion, transient ECG signs of LAE during EST represent a highly specific sign of reversible ischemia and are frequently associated with multivessel CAD. Although less sensitive than classical ST criteria, this sign may prove useful in patients exhibiting equivocal ST changes and in the presence of ventricular conduction disturbances.

Translated title of the contributionLeft atrial enlargement during the exercise test: a new electrocardiographic sign of transitory ischemia
Original languageItalian
Pages (from-to)495-498
Number of pages4
JournalCardiologia
Volume35
Issue number6
Publication statusPublished - Jun 1990

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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