Key result
Combined exercise ECG and stress echo predicts myocardial ischemia better than either test alone.
Why the study?
Does combined exercise electrocardiography and stress echocardiography improve diagnostic efficiency for myocardial ischemia compared to either test alone in adults with suspected MI?
Cross-Sectional (n=278)
Independent interpretation by three cardiologists
No
Does combined exercise electrocardiography and stress echocardiography improve diagnostic efficiency for myocardial ischemia compared to either test alone in adults with suspected MI?
Combining exercise electrocardiography with stress echocardiography improves the diagnostic accuracy for detecting myocardial ischemia compared to using either modality alone.
May support combined testing for suspected ischemia; hypothesis-generating from cross-sectional data, needing prospective validation.
Myocardial ischemia (MI) has the highest mortality rate in the world. Traditional noninvasive MI examinations include exercise electrocardiography tests (EETs) and stress echocardiography (SE). Treadmill and dobutamine tests are commonly used as stress protocols. In the present study, 278 patients with suspected MI were examined, 66 of whom were diagnosed with MI and 212 did not show evidence of MI by coronary angiography (CAG)/coronary CT angiography (CCTA). All patients underwent clinical EET and SE evaluations prior to CAG/CCTA. All groups were compared based on specific clinical parameters including age, sex, blood pressure, heart rate, blood oxygen saturation, underlying conditions and ejection fraction/fraction shortening. The data indicated superior diagnostic efficiency of the combined EET+SE method for the diagnosis of suspected MI compared with either EET or SE alone. The sensitivity/specificity/positive predictive value and negative predictive value for detecting MI were excellent compared with those of traditional examinations. The diagnostic efficiency of the combination analysis may reduce the prevalence of MI and medical costs. The present study provided novel insight for the development of methods that may be used for MI detection and prediction.
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Huang et al. (2020) conducted a cross-sectional in Suspected myocardial ischemia (n=278). Exercise electrocardiography combined with stress echocardiography vs. Exercise electrocardiography or stress echocardiography alone was evaluated on Area under the ROC curve (AUC) for predicting myocardial ischemia (AUC 0.728, 95% CI 0.65-0.80, p=<0.001). The combination of exercise electrocardiography and stress echocardiography yielded an AUC of 0.728 for predicting myocardial ischemia, demonstrating superior diagnostic efficiency compared to either test alone.
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