Key result
Combining high-frequency QRS analysis with exercise stress echocardiography provided superior diagnostic accuracy for detecting significant coronary artery disease (AUC 0.948) compared to conventional ST-segment analysis (AUC 0.679).
Why the study?
Does combining high-frequency QRS (HFQRS) analysis with exercise stress echocardiography (ESE) improve diagnostic accuracy for detecting significant coronary artery disease compared to conventional ST-segment analysis?
Cross-Sectional (n=175)
Single-blind
No
Does combining high-frequency QRS (HFQRS) analysis with exercise stress echocardiography (ESE) improve diagnostic accuracy for detecting significant coronary artery disease compared to conventional ST-segment analysis?
Absolute Event Rate: 0.948% vs 0.679%
Combining high-frequency QRS analysis with exercise stress echocardiography significantly improves the diagnostic accuracy for detecting coronary artery disease compared to conventional ST-segment analysis.
May enhance CAD detection when added to stress echocardiography; leaves open larger validation trials before practice change.
BACKGROUND AND OBJECTIVES: Because the exercise treadmill test (ETT) based on ST-segment analysis is limited due to low sensitivity and specificity, there has been an interest in the additional analysis of high-frequency components of QRS (HFQRS) for the detection of coronary artery disease (CAD). We sought to evaluate the feasibility and clinical usefulness of HFQRS analysis during exercise stress echocardiography (ESE). SUBJECTS AND METHODS: We evaluated 175 patients (age 57±9,118 men) who performed ESE and either coronary computed tomographic angiography or coronary angiography. ETT was performed using the HyperQ stress system for both conventional ST-segment analysis and HFQRS intensity analysis. RESULTS: Thirty-two patients (31%) had significant CAD. The sensitivity and specificity of HFQRS analysis were 68.8% and 74.8%, respectively. The combined model, including HFQRS analysis and ESE, provided the best diagnostic accuracy, with the area under the receiver-operating characteristics curve (AUC) of 0.948 {95% confidence interval (CI)=0.913-0.984} compared with ST-segment analysis (AUC 0.679, 95% CI=0.592-0.766). CONCLUSION: HFQRS analysis during ESE is feasible and may provide additional diagnostic information for the detection of significant CAD.
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Choi et al. (2013) conducted a cross-sectional in Coronary artery disease (n=175). Combined high-frequency QRS (HFQRS) analysis and exercise stress echocardiography (ESE) vs. Conventional ST-segment analysis was evaluated on Diagnostic accuracy (Area under the ROC curve) for detecting significant coronary artery disease (95% CI 0.913-0.984). Combining high-frequency QRS analysis with exercise stress echocardiography provided superior diagnostic accuracy for detecting significant coronary artery disease (AUC 0.948) compared to conventional ST-segment analysis (AUC 0.679).
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