الفهرس 
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Abstract
Aim of the work
Is to reevaluate the safety, applicability and validity of the exponential exercise protocol in IHD and evaluate the QT dispersion as a parameter of ischemia during exercise protocols.
Conclusion
We might conclude that STEEP is a protocol based on short stages with exponential increments in workload. The potential advantage of this protocol is that it is suitable for a wide range of patients. The most severely limited patients should manage the initial low workloads; while the expotential rise in workload terminates the test within 15 minute before boredom and fatigue become limiting factors. The treadmill test is unlikely to intimidiate patients because the increments are small and simultaneous increases in speed and gradient are avoided.
This protocol can accommodate a wide range of subjects and allowing the patients to perform well even with limited exercise capacity and this gives good chance for myocardial ischemia to be detected.
STEEP protocol allowed achievement of a higher heart rate and oxygen consumbtion than Bruce.
This protocol has the same sensitivity and specificity as the Bruce protocol. So now we have a new protocol (STEEP protocol) with many advantages that overcome the disadvantages of the Bruce protocol with the same sensitivity and specificity.
QT & QT c dispersion is a sensitive non-invasive tool for detecting myocardial ischemia, ventricular arrhythmias and risk of sudden cardiac death.
The increased in QT & QTc dispersion during rest and at peak exercise is proved to be a sensitive method for detecting IHD and may improve the sensitivity and specificity of the stress test.