El infradesnivel del segmento ST que se presenta o se profundiza durante la fase de recuperación: su aporte a la utilidad clínica de la ergometría

background despite the current availability of diagnostic image tests with excellent diagnostic and prognostic accuracy, exercise stress testing (est) remains as the procedure most commonly used for the evaluation, diagnosis and risk stratification of patients with coronary artery disease (cad). objectives 1) to investigate the clinical usefulness of significant exercise-induced st-segment depression (st-d) occurring or increasing during the recovery phase of exercise stress test and to compare it with significant st-segment depression presenting during the active phase of exercise; 2) to evaluate the clinical data and the information provided by est and coronary angiography. material and methods clinical and est data from 147 patients with positive stress test were analyzed. all patients had significant st-segment depression and were divided into three groups: gi, 94 patients with st-d during exercise; gii, 29 patients with st-d only during the recovery phase; and giii, 24 patients with borderline st-d during exercise which became significant during the recovery phase. the results of the est were correlated with the coronary angiography findings in each group. results a diagnosis of significant cad was made in 78 patients in gi (82.9%), in 22 in gii (75.8%) and in 21 in giii (87.5%),(p = 0.52). patients in giii were older, with high prevalence of dyslipemia, history of previous infarction and three-vessel and/or left main coronary artery disease. gii presented the higher number of asymptomatic patients with one-vessel disease and high prevalence of cad. conclusions there were no statistical differences in the percentage of patients with significant cad among the groups. patients in giii had high prevalence of significant and severe cad. a proper evaluation of st-d occurring or becoming significant during the recovery phase provided additional clinical information to the results of the est.