The diagnosis of coronary insufficiency by the combined dynamic-postexercise electrocardiographic test

Analysis of the results of the Dynamic Exercise and Post-Exercise ECG tests given to 206 young normal subjects and to 302 patients with probable, presumptive, or definite evidence of coronary heart diseases revealed the following1. Using ischemic ST depression of at least 1.0 mm as the sole criterion for a positive test, the Dynamic Exercise ECG did not give more "false positive" results than the Post-Erxercise ECG in the known normal subjects while in the "coronary" patients, the Dynamic Exercise ECG detected almost five times as many coronary insufficiencies as the Post-Exercise ECG2. Junctional ST depressions of 1.5 mm or more in the Post-Exercise ECG were found to be residuals of previous ischemic ST depressions in about 60 per cent of cases, and should therefore be regarded as suspicious indications of coronary insufficiency whenever the Dynamic Exercise ECG is unavailable3. The significance of and the possibility of the inclusion of "prolonged" QTc interval as a criterion to increase the sensiitivity of the Exercise Test was discussed4. Despite the demonstrated superiority of the Dynamic Eercise ECG it had a few limitations which the post exercise ECG could compensate. In view of this, it was recommended that the two exercise ECG tests be combined for which the name "Combined Dynamic-Post-exercise ECG Test" was proposed."(Summary and Conclusions)

Which monotherapy for hypertension

The comparative blood pressure lowering and hemodynamic effects of four types of antihypertensive drugs, i.e.indapamide (diuretic), atenalol (betablocker), verapamil (calcium antagonist), and captopril (converting enzyme inhibitor), were evaluated among 30 middle aged men with mild to moderate essential hypertension in a double-blind randomized multiple crossover study. Blood pressure reduction were comparable regardless of hypotensives used. However atenolol 100 mg once daily also produced significant reduction in exercise-induced rate-pressure product and improved LV compliance echocardiogram indices within 2 weeks. Antihypertensive therapy is lifelong. Thus a daily single dose drug is advantageous for better patient acceptability and compliance during longterm antihypertensive therapy.(Auth)