[Diagnostic availability of R wave changes during effort test for a diagnosis of coronary artery disease (author's transl)].

New ecgraphic criteria has been proposed to improve diagnostic availability of R wave changes (delta R) and algebra summation of delta R and ST segment depression (delta RST) in comparison to the criterion of ST depression (ST). The AA. considered as a positive test for a diagnosis of coronary artery disease (CAD): delta R and delta RST values greater than or equal to 0. In 69 patients with stenosis, 75% of at least one major coronary vessel, delta RST showed correct diagnosis in 87% of cases, R in 81% and ST in 73%. RST sensitivity was better than that of ST (P = 0,02). In 44 patients with normal coronaries delta RST was able to correct diagnosis in 52% of cases, delta R in 57% and ST in 73%. ST specificity was better than that of delta RST (P = 0,04). Predictive accuracy was comparable for the three criteria. In normal healthy subjects everyone with an exercise test negative for CAD, with ST analysis, delta R and delta RST was 0 in 16% of cases. New ecgraphic criteria, also showing a better sensitivity in comparison with ST segment analysis, have a worsened specificity. The Authors do not consider these methods a significant improvement in ecgrahic evaluation of exercise test.