Key result
ECG V6/III R-wave ratio distinguishes ischemic from dilated cardiomyopathy with ~94% sensitivity.
Why the study?
Differentiating coronary artery disease with left ventricular dysfunction from dilated cardiomyopathy is important prognostically and therapeutically, but noninvasive diagnostic algorithms are needed.
Can a standard 12-lead electrocardiogram differentiate ischemic from dilated cardiomyopathy in patients with left ventricular ejection fraction < 50%?
Observational (n=105)
Can a standard 12-lead electrocardiogram differentiate ischemic from dilated cardiomyopathy in patients with left ventricular ejection fraction < 50%?
Specific 12-lead ECG parameters, such as pathologic Q waves and R-wave amplitude ratios, can help noninvasively differentiate ischemic from dilated cardiomyopathy in patients with left ventricular systolic dysfunction.
May support noninvasive differentiation of ischemic from dilated cardiomyopathy; leaves open prospective validation before practice change.
Differentiating coronary artery disease with left ventricular dysfunction from dilated cardiomyopathy is important prognostically and therapeutically. To provide a diagnostic algorithm to distinguish these conditions using a standard 12-lead electrocardiogram, all 105 patients with left ventricular ejection fraction < 50% who underwent angiography between January 2004 and December 2006 were studied prospectively. Coronary artery disease was defined as >/= 50% stenosis of the left main coronary artery or >/= 70% stenosis of 1 or more of the 3 major epicardial arteries. Normal coronary angiography findings with left ventricular ejection fraction < 50% was defined as dilated cardiomyopathy. The most specific finding for differentiation of these diseases was pathologic Q waves in lead II, aVF, V3 or V4. The most sensitive parameter was a ratio >/= 5 of R-wave amplitudes in lead V6 and lead III (94% sensitive). The 12-lead electrocardiogram provides a useful noninvasive method for differentiation of dilated cardiomyopathy from coronary artery disease with left ventricular systolic dysfunction.
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Aghasadeghi et al. (2008) conducted an observational in Ischemic and Dilated Cardiomyopathy (n=105). 12-lead electrocardiogram vs. Angiography was evaluated on Differentiation of ischemic and dilated cardiomyopathy. A standard 12-lead electrocardiogram differentiated ischemic from dilated cardiomyopathy, with an R-wave amplitude ratio ≥5 in lead V6 to lead III demonstrating 94% sensitivity.
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