Comparison of computerized exercise ECG parameters in detecting myocardial ischemia

The exercise ECG test is the most widely used method of evaluating myocardial ischemia, but its diagnostic accuracy is only about 70 %. Many studies introducing different diagnostic computerized exercise ECG parameters have been published, but according to the authors´ knowledge there is no overall comparison of these parameters. We calculated 52 exercise ECG parameters from the ST-segment value, ST-segment shape and ST-segment/heart rate slope and compared the diagnostic power of these parameters by ROC-analysis. We found that ST-segment/heart rate slope has better diagnostic power than ST-segment depression or ST-segment shape alone. Another result was that the ST-segment shape seemed to be better diagnostic parameter than ST-segment depression when measuring an individual lead. However, further research with larger patient material is needed to get statistically significant differences between the parameters.