Exercise QRS Score in Patients with Coronary Artery Disease: An Indicator of Extent of Ischemia on Myocardial Perfusion Scintigraphy

Exercise-induced changes in Q, R and S wave amplitudes and their incorporation into a composite index (Athens QRS score) have been reported to increase the diagnostic value of exercise ECG. The aim of this study was to compare this score with findings on exercise myocardial perfusion scintigraphy (MPS). One-lıundred and eighteen consecutive patients (65 men, 53 women; mean age 56 ± 7) who underwent coronary angiography (CA) and exercise SPECT MPS were prospectively included in the study. Patients with previous myocardial infarction, left ventricular hyperthrophy and left bundle branch block were excluded. Athens QRS score was calculated based on the exercise induced changes of the Q, R and S wav es in derivations a VF and V5. Considering QRS score <0 mm as a marker of ischemia on exercise ECG, sensitivity and specificity of exercise ECG for the diagnosis of CAD were found to be 82% and 84%, respectively. Patients were divided into three groups according to the findings of CA and MPS. Group I consisted of patients who had at least one ischemic segment on MPS and significant coronary artery disease (CAD) in CA. Group II included patients with CAD in angiography, but without any ischemic segment on MPS, Group III consisted of patients with both normal CA and MPS. The mean QRS score of Groups I, II and III were fo und to be -4.5 ± 4.1 mm, 0.4 ± 2.5 and 0.8 ± 4.4 mm, respectively" The mean QRS score of Group I patients was significantly lower than those of Group II and III patients (pKeywords: Coronary artery disease, myocardial perfusion scintigraphy, QRS score