Author + information
- ↵1Address for reprints: Victor Froelicher, MD, Cardiac Rehabilitation and Exercise Testing, University Hospital, 225 Dickinson Street, San Diego, California 92103.
Because it will be some time before the primary prevention of cardiovascular disease is a reality, it is advisable to evaluate screening methods for detecting latent cardiovascular disease. Because risk factor screening and techniques with the patient at rest have limited sensitivity, exercise testing that brings out abnormalities not present at rest deserves consideration. Numerous studies have shown the exercise electrocardiogram to have a sensitivity of approximately 50% and a specificity of 90%. The different reported predictive values are related to its use in populations with different prevalences of disease. Various techniques have been recommended to improve the sensitivity and specificity of exercise testing, including other exercise measurements, computerized probability estimates, nuclear cardiology, cardio-kymography, cardiac fluoroscopy and risk factor analysis. There is promise that these techniques will improve attempts to screen asymptomatic subjects for coronary disease.
This study was supported in part by the Specialized Center of Research on lschemic Heart Disease, National Institutes of Health Research Grant HL-17682 awarded by the National Heart, Lung, and Blood Institute. Bethesda. Maryland, to John Ross, Jr. MD.
- American College of Cardiology Foundation