Comparison of Five Different Stress Testing Methods in the ECG Diagnosis of Coronary Artery Disease

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Abstract
Stress testing methods (5): bicycle ergometer exercise (BE), treadmill exercise (TD), isoproterenol infusion test (IPN), dopamine infusion test (DPM) and atrial pacing (AP) were performed on 90 male patients who underwent coronary arteriography. Ischemic S-T segment depression of 1.0 mm or greater was used as the criterion for a positive test. Within the group of 56 subjects having significant coronary artery disease (CAD) the diagnostic sensitivity of the single tests was as follows: 64.3% for BE, 66.1% for TD, 69.6% for IPN, 41.1% for DPM and 75.0% for AP. For the 34 subjects with no CAD the following specificity was found: 88.2% for BE and for TD, 82.3% for IPN, 85.3% for DPM and 63.8% for AP. Apparently when the results of the different tests were combined the association of an ergometric test with IPN enhanced the sensitivity of the exercise test (P < 0.05) without significantly decreasing the specificity.