Key result
Combining QRS-loop parameters with conventional ST-Vector Magnitude identified ischemic patients with 88.5% sensitivity and 92.1% specificity, compared to 73.2% and 73.9% for ST(VM) alone.
Why the study?
Does the combination of QRS-loop parameters and ST(VM) improve the diagnostic accuracy for identifying ischemic patients compared to ST(VM) alone?
Case-Control (n=132)
Does the combination of QRS-loop parameters and ST(VM) improve the diagnostic accuracy for identifying ischemic patients compared to ST(VM) alone?
The addition of QRS-loop parameters to conventional ST-vector magnitude analysis significantly improves the sensitivity and specificity of vectorcardiograms for detecting cardiac ischemia.
May enhance vectorcardiographic detection of ischemia; hypothesis-generating and requires prospective validation before clinical adoption.
New signal processing techniques have enabled the use of the vectorcardiogram (VCG) for the detection of cardiac ischemia. Thus, we studied this signal during ventricular depolarization in 80 ischemic patients, before undergoing angioplasty, and 52 healthy subjects with the objective of evaluating the vectorcardiographic difference between both groups so leading to their subsequent classification. For that matter, seven QRS-loop parameters were analyzed, i.e.: (a) Maximum Vector Magnitude; (b) Volume; (c) Planar Area; (d) Maximum Distance between Centroid and Loop; (e) Angle between XY and Optimum Plane; (f) Perimeter and, (g) Area-Perimeter Ratio. For comparison, the conventional ST-Vector Magnitude (ST(VM)) was also calculated. Results indicate that several vectorcardiographic parameters show significant differences between healthy and ischemic subjects. The identification of ischemic patients via discriminant analysis using ST(VM) produced 73.2% Sensitivity (Sens) and 73.9% Specificity (Spec). In our study, the QRS-loop parameter with the best global performance was Volume, which achieved Sens=64.5% and Spec=74.6%. However, when all QRS-loop parameters and ST(VM) were combined, we obtained Sens=88.5% and Spec=92.1%. In conclusion, QRS loop parameters can be accepted as a complement to conventional ST(VM) analysis in the identification of ischemic patients.
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Correa et al. (2012) conducted a case-control in Cardiac ischemia (n=132). Vectorcardiogram (VCG) QRS-loop parameters combined with ST-Vector Magnitude vs. ST-Vector Magnitude alone was evaluated on Identification of ischemic patients (Sensitivity and Specificity). Combining QRS-loop parameters with conventional ST-Vector Magnitude identified ischemic patients with 88.5% sensitivity and 92.1% specificity, compared to 73.2% and 73.9% for ST(VM) alone.
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