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El infradesnivel del segmento ST que se presenta o se profundiza durante la fase de recuperación: su aporte a la utilidad clínica de la ergometría.;
Clinical Usefulness of Exercise-Induced ST-Segment Depression Occurring or Increasing during the Recovery Phase

Creators:Crudo, Norma, Castellano, José, Piombro, Alfredo, Szarfer, Jorge, Gagliardi, Juan, Vidal, Luis
2012-01-20

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Descripción

IntroducciónNo obstante la disponibilidad actual de estudios por imágenes que brindan una muy buena capacidad diagnóstica y de evaluación, la prueba ergométrica graduada (PEG) está reconocida como un estudio importante y continúa siendo el procedimiento más utilizado para la evaluación, el diagnóstico y la estratificación de riesgo de los  pacientes con enfermedad arterial coronaria (EAC).Objetivos1) Investigar el valor clínico de la presencia durante una ergometría del infradesnivel del segmento ST (infra-ST) significativo que aparece sólo durante la fase de recuperación o del que es dudoso durante la fase de ejercicio pero que se profundiza tornándose positivo durante la fase de recuperación de la PEG y compararlos con el infra-ST significativo que se presenta durante la fase activa de ejercicio. 2) Evaluar los datos clínicos, ergométricos y de la angiografía coronaria de los pacientes. Material y métodosSe analizaron los datos clínicos y ergométricos de 147 pacientes con PEG positiva por infra-ST significativo, que en 94 pacientes (GI) se presentó durante la fase de ejercicio, en 29 (GII) sólo en la fase de recuperación y en 24 (GIII) fue dudoso durante el ejercicio, pero se profundizó tornándose significativo en la fase de recuperación. En cada grupo se realizó una correlación entre los resultados de la PEG y los hallazgos de la coronariografía. ResultadosSe diagnosticó EAC significativa en 78 pacientes del GI (82,9%), 22 del GII (75,8%) y 21 del GIII (87,5%) (p = 0,52). El GIII reunió los pacientes de edad más avanzada y con alta prevalencia de dislipidemia, antecedente de infarto previo y lesión de tres vasos y/o del tronco de la coronaria izquierda. El GII presentó el mayor número de pacientes asintomáticos, con lesión de un vaso y alta prevalencia de historia familiar de EAC. ConclusionesNo se observaron diferencias estadísticas en el porcentaje de pacientes con EAC significativa entre los grupos. Los pacientes del GIII mostraron alta prevalencia de enfermedad coronaria extensa y grave. La evaluación correcta del infra-ST que aparece o se  profundiza durante la fase de recuperación aumentó la información clínica que aporta una ergometría.

BackgroundDespite the current availability of diagnostic image tests withexcellent diagnostic and prognostic accuracy, exercise stresstesting (EST) remains as the procedure most commonly usedfor the evaluation, diagnosis and risk stratification of patientswith coronary artery disease (CAD).Objectives1) To investigate the clinical usefulness of significantexercise-induced ST-segment depression (ST-d) occurring orincreasing during the recovery phase of exercise stress testand to compare it with significant ST-segment depressionpresenting during the active phase of exercise; 2) to evaluatethe clinical data and the information provided by EST andcoronary angiography.Material and MethodsClinical and EST data from 147 patients with positive stresstest were analyzed. All patients had significant ST-segmentdepression and were divided into three groups: GI, 94 patientswith ST-d during exercise; GII, 29 patients with ST-d only duringthe recovery phase; and GIII, 24 patients with borderlineST-d during exercise which became significant during therecovery phase. The results of the EST were correlated withthe coronary angiography findings in each group.ResultsA diagnosis of significant CAD was made in 78 patients inGI (82.9%), in 22 in GII (75.8%) and in 21 in GIII (87.5%) (p = 0.52). Patients in GIII were older, with high prevalenceof dyslipemia, history of previous infarction and three-vesseland/or left main coronary artery disease. GII presented thehigher number of asymptomatic patients with one-vesseldisease and high prevalence of CAD.ConclusionsThere were no statistical differences in the percentage ofpatients with significant CAD among the groups. Patientsin GIII had high prevalence of significant and severe CAD.A proper evaluation of ST-d occurring or becoming significantduring the recovery phase provided additional clinicalinformation to the results of the EST.

Metadatos destacados

Colecciones
Argentine Journal of Cardiology

Editor

Sociedad Argentina de Cardiología

Fuente

Revista Argentina de Cardiología; Vol 80, No 1 (2012), Argentine Journal of Cardiology; Vol 80, No 1 (2012)

Citación

Crudo, Norma et al., “El infradesnivel del segmento ST que se presenta o se profundiza durante la fase de recuperación: su aporte a la utilidad clínica de la ergometría.,” Archivo PPCT, consulta 2 de abril de 2026, http://archivoppct.caicyt.gov.ar/items/show/8042.

Dublin Core

Materia

Autor

Crudo, Norma
Castellano, José
Piombro, Alfredo
Szarfer, Jorge
Gagliardi, Juan
Vidal, Luis

Fuente

Revista Argentina de Cardiología; Vol 80, No 1 (2012)
Argentine Journal of Cardiology; Vol 80, No 1 (2012)

Editor

Sociedad Argentina de Cardiología

Fecha

2012-01-20

Derechos

Los que firman al pié, certificamos que tenemos total responsabilidad por la conducción de este estudio y por el diseño y la interpretación de los datos. Nosotros escribimos el manuscrito y somos responsables por la decisión acerca del mismo. Cada uno de nosotros cumple la definición de autor como se afirma en el Comité Internacional de Editores de Revistas Médicas (International Committee of Medical Journal Editors, ver www.icmje.org). Nosotros hemos visto y aprobado el manuscrito final. Ni el artículo, ni ninguna parte esencial del mismo, incluido las tablas y las figuras, será publicado o admitido para arbitrar a otra parte antes de aparecer en la Revista.También notificamos haber leído la sección “conflicto de intereses”, y revelaríamos cualquiera que existiera. Dejamos constancia que si nuestro artículo se publicara en la RAC, cederíamos los derechos (copyright) a la Revista.Los documentos publicados en esta revista están bajo la licencia Creative Commons Atribución-NoComercial-Compartir-Igual 2.5 Argentina.
Those signing below certify that we have full responsibility for the conduction of this study and for the design and interpretation of the information. We wrote the manuscript and are responsible for its decision. Each of us fulfills the definition of authorship as stated by the International Committee of Medical Journal Editors ( www.icmje.org). We have signed and approved the final manuscript. Neither the manuscript, nor any essential part thereof, including tables and figures, will be published or accepted for refereeing elsewhere before being published in the Journal. We have also read the "Conflict of Interest" section and would disclose any existing. We state that if our manuscript is published in the RAC, we shall transfer the copyright to the Journal.

Formato

Idioma

eng
spa

Tipo

info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion