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Gender aspects on exercise‐induced ECG changes in relation to scintigraphic evidence of myocardial ischaemia
Author(s) -
Akil Shahnaz,
Hedén Bo,
Pahlm Olle,
Carlsson Marcus,
Arheden Håkan,
Engblom Henrik
Publication year - 2018
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1111/cpf.12483
Subject(s) - medicine , cardiology , heart rate , blood pressure , stress testing (software) , perfusion , electrocardiography , computer science , programming language
Summary Background This retrospective study aimed to determine the diagnostic performance of exercise‐induced ST response in relation to findings by myocardial perfusion single photon emission computed tomography ( MPS ), with focus on gender differences, in patients with suspected or established stable ischemic heart disease. Methods MPS findings of 1 021 patients (518 females) were related to the exercise‐induced ST response alone (blinded and unblinded to gender) and ST response together with additional exercise stress test ( EST ) variables (exercise capacity, blood pressure and heart rate response). Results Exercise‐induced ischaemia by MPS was found in 9% of females and 23% of males. Diagnostic performance of exercise‐induced ST response in relation to MPS findings in females versus males was: sensitivity = 48%,70%; specificity = 67%, 64%; PPV = 13%, 38%; NPV = 93%, 87%. Adding more EST variables to the ST response interpretation yielded in females vs males: sensitivity = 44%, 51%; specificity = 84%, 83%; PPV = 22%, 48% and NPV = 93%, 85%. Conclusions In patients who have performed EST in conjunction with MPS , there is a gender difference in the diagnostic performance of ST response at stress, with a significantly lower PPV in females compared to males. For both genders, specificity can be significantly improved, and a higher PPV can be obtained, while the sensitivity might be compromised by considering more EST variables, in addition to the ST response.