A Study on the Sensitivity of CASE(Computer-Assisted System for Exercise) Analysis to Overall Clinical Assessment

Many investigators have shown that computer analysis of exercise induced ST segment changes in feasible and valid. This technique should make it possible to achieve uniformity of interpretation.

Though myocardial ischemic response, arrhythmia, R wave amplitude and heart rate changes are documented by CASE exactly, blood pressure change, subjective and objective signs are assessed clinicall only. Therefore, both CASE and clinical analysis are demanded for the precise interpretation of GXT.

Two hundred and ten patients, aged 22-68 y/o, were evaluated for comparative analysis between CASE and clinical assessment.

The following results were obtained;

1) The sensitiivity of CASE to clinical analysis is 70.2%.

2) Among the 40 cases with ST segment-positive response, 24 cases(60%) had a less than 2mm ST depression and 16 cases(40%) had a more than 2mm ST depression.

3) Among the 40 cases with ST segment-positive response, 30 cases(75%) had a increased in R wave amplitude of 2.8mm in average, while among the 153 cases with GXT-negative response, 61 cases(39.9%) had R wave increase of 1.5mm in average.

4) Increment of systolic blood pressure per MET was 5.6 mmHg. There was no significant difference by age.