Key result
Dipyridamole stress portable SAECG detects CAD with 97% sensitivity using filtered QRS duration changes.
Why the study?
Whether patients with coronary artery disease can be easily detected at the bedside using dipyridamole stress with portable signal-averaged electrocardiography was investigated.
Does portable dipyridamole-stress SAECG accurately detect coronary artery disease and myocardial ischemia at the bedside?
Cross-Sectional (n=63)
No
Does portable dipyridamole-stress SAECG accurately detect coronary artery disease and myocardial ischemia at the bedside?
Portable dipyridamole-stress SAECG provides a convenient and highly accurate bedside method for detecting coronary artery disease and myocardial ischemia.
May support bedside CAD detection with portable SAECG; hypothesis-generating in Level 4 case-control data requiring prospective validation.
BACKGROUND: Whether or not patients with coronary artery disease (CAD) could be easily detected at the bedside using dipyridamole stress was investigated using a portable type signal-averaged electrocardiography (portable SAECG). METHODS AND RESULTS: The standard 12-lead QRS wave SAECG was performed at the bedside before and after dipyridamole stress in 30 patients with angiographically significant stenotic lesions, who had positive myocardial ischemia in the dipyridamole-thallium myocardial perfusion imaging (CAD group), and 33 patients with no significant stenotic lesions, who had negative imaging (control group). The filtered QRS duration (fQRSd) before and after dipyridamole stress was determined by the vector magnitude method and the difference (DeltafQRSd) was obtained. Furthermore, the DeltafQRSd was obtained using the multiphasic oscillation method, as well at the same standard 12-lead, and the maximal value of changes in fQRSd (MAX DeltafQRSd) between the 12 leads was determined. The DeltafQRSd was similar between 2 groups (p = 0.11). The MAX DeltafQRSd associated was significantly greater in the CAD group (p < 0.0001). When a cut-off value of MAX DeltafQRSd > or = 5 ms was used for the detection of CAD, the sensitivity and specificity were 97 and 94%, respectively. CONCLUSION: The portable dipyridamole-stress SAECG easily detect CAD and myocardial ischemia at the bedside.
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Matsumoto et al. (2005) conducted a cross-sectional in Coronary Artery Disease (n=63). Dipyridamole stress portable signal-averaged electrocardiography vs. Patients without significant coronary artery stenosis was evaluated on Maximal change in filtered QRS duration (MAX ∆fQRSd) using the multiphasic oscillation method (p=<0.0001). Dipyridamole stress portable signal-averaged electrocardiography identified patients with coronary artery disease with 97% sensitivity and 94% specificity using a MAX ∆fQRSd cutoff of ≥5 ms.
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