Key result
Ambulatory electrocardiographic monitoring demonstrated that women with ischemic heart disease had a significantly higher ischemic load (15.23% vs 4.7%) and longer ischemia duration than controls.
Why the study?
Ischemic heart disease is the leading cause of mortality in women, motivating an evaluation of ambulatory electrocardiographic monitoring as a diagnostic test.
Can 24-hour ambulatory electrocardiographic monitoring (AECGm) accurately diagnose ischemic heart disease in women?
Case-Control (n=225)
No
Can 24-hour ambulatory electrocardiographic monitoring (AECGm) accurately diagnose ischemic heart disease in women?
Ambulatory ECG monitoring can help diagnose ischemic heart disease in women using threshold values of ischemic load (>27%) and ischemic duration (>315 minutes).
Answers are grounded in this paper and cite their sources.
May support AECG thresholds for IHD detection in women; hypothesis-generating, requires prospective validation before clinical use.
Introduction. Ischemic heart disease(IHD) is currently the leading cause of mortality in women. In this study we aimed to evaluate ambulatory electrocardiographic monitoring(AECGm) as a diagnostic test for IHD in women. Material and method. The study included 225 female who underwent AECGm divided into 2 groups: 136 previously diagnosed with IHD(IHD+) and 89 controls(IHD-). The IHD+ group was subdivided into AECGm ischemia subgroup(I+) and AECGm non-ischemia subgroup(I-). AECGm was assessed for presence of myocardial ischemia (ST segment depression >5mm), duration and ischemic load (the percentage that episodes of myocardial ischemia accounted throughout the recording). Results and discussions. Patients mean age was 62.31±12.51years. The IHD+ and IHD- groups were similar regarding associated risk factors (hypertension, obesity, dyslipidemia, diabetes mellitus), echocardiographic parameters (left ventricular size, ejection fraction, kinetic disorders), minimum and maximum heart rates(MaxHR) on AECGm. Statistically significant differences were identified regarding presence of atrial fibrillation episodes(AFibE) (IHD+:21.3% vs IHD-:8.9%), myocardial ischemia (IHD+:55.14% vs IHD-:42.69%), ischemic load (IHD+:15.23±30.54% vs IHD-:4.7±15.65%), duration of ischemia (IHD+:174.16±380.75 minutes vs IHD-:59.44 ± 209.02 minutes). In multivariate analysis, ischemia episodes, ischemic load and duration of ischemia were predicted by obesity, MaxHR and AFibE. Statistically significant differences were also identified regarding presence of AFibE (I+:30% vs I-:8.9%), MaxHR (I+:120 vs I-:111beats/minute), obesity (I+:20% vs I-:41%), diabetes mellitus (I+:16% vs I-:69%), hypertension (I+:76% vs I-:90%). Conclusions. Although myocardial ischemia was also present in IHD- group, our study demonstrated that the diagnosis of IHD can be established by AECGm using the threshold values of ischemic load (> 27%) and ischemic duration (> 315minutes).
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Pop et al. (2020) conducted a case-control in Ischemic heart disease (n=225). Ambulatory electrocardiographic monitoring (AECGm) vs. Controls without ischemic heart disease was evaluated on Ischemic load (percentage of myocardial ischemia episodes throughout the recording) (p=0.000703). Ambulatory electrocardiographic monitoring demonstrated that women with ischemic heart disease had a significantly higher ischemic load (15.23% vs 4.7%) and longer ischemia duration than controls.
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