Treadmill stress test using body surface mapping in coronary artery disease. The clinical significance of ST depression.

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Abstract
Whether the size of the ST-depression area, which was measured by body surface maps recorded before and after treadmill exercise, could be a useful indicator for quantitatively evaluating coronary artery disease (CAD) was assessed in 27 patients with coronary artery disease. The patients were divided into 3 groups on the basis of the findings of left ventriculograms: patients with anterior asynergy (n = 6), those with inferior asynergy (n = 6) and those with no asynergy (n = 15). Coronary arteriograms were evaluated according to Pujadas, and .SIGMA. Grade, as an index of the severity of CAD, was developed by adding the grade numbers of the 4 main coronary stems (right coronary artery, main trunk of the left coronary artery, left anterior descending artery and left circumflex artery). Patients with inferior asynergy and with no asynergy have ST-depression areas in proportion to their .SIGMA. Grade (r = 0.845, P < 0.001), whereas none of the patients with anterior asynergy showed ST-depression areas regardless of their .SIGMA. Grade. Of 6 patients who had anterior asynergy, 5 (83%) had pathologic Q waves in the left anterior chest leads. These findings emphasize the clinical value of the ST-depression area for the quantitative and non-invasive diagnosis of CAD, especially in patients without pathologic Q waves in the left anterior chest leads.

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