Accuracy of advanced versus strictly conventional 12-lead ECG for detection and screening of coronary artery disease, left ventricular hypertrophy and left ventricular systolic dysfunction
| Autor: | E Carl Greco, Alan H. Feiveson, Michael W. Bungo, Terry Bauch, Rubén Medina, Matthew J. Hayat, M. Atiar Rahman, Reynolds M. Delgado, Stafford G. Warren, Olle Pahlm, Håkan Arheden, Todd T. Schlegel, Tulio Núñez-Medina, Diego Jugo, Jude L. DePalma, Bojan Vrtovec, Vito Starc, Walter B. Kulecz |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male lcsh:Diseases of the circulatory (Cardiovascular) system medicine.medical_specialty Coronary Artery Disease Left ventricular hypertrophy Sensitivity and Specificity Muscle hypertrophy Coronary artery disease Electrocardiography Ventricular Dysfunction Left Predictive Value of Tests Internal medicine Research article medicine Humans cardiovascular diseases Aged Retrospective Studies Angiology medicine.diagnostic_test business.industry Retrospective cohort study Middle Aged medicine.disease Cardiac surgery Research Design lcsh:RC666-701 Predictive value of tests Cardiology Female Hypertrophy Left Ventricular Cardiology and Cardiovascular Medicine business |
| Zdroj: | BMC Cardiovascular Disorders, Vol 10, Iss 1, p 28 (2010) BMC Cardiovascular Disorders |
| ISSN: | 1471-2261 |
| DOI: | 10.1186/1471-2261-10-28 |
| Popis: | Background Resting conventional 12-lead ECG has low sensitivity for detection of coronary artery disease (CAD) and left ventricular hypertrophy (LVH) and low positive predictive value (PPV) for prediction of left ventricular systolic dysfunction (LVSD). We hypothesized that a ~5-min resting 12-lead advanced ECG test ("A-ECG") that combined results from both the advanced and conventional ECG could more accurately screen for these conditions than strictly conventional ECG. Methods Results from nearly every conventional and advanced resting ECG parameter known from the literature to have diagnostic or predictive value were first retrospectively evaluated in 418 healthy controls and 290 patients with imaging-proven CAD, LVH and/or LVSD. Each ECG parameter was examined for potential inclusion within multi-parameter A-ECG scores derived from multivariate regression models that were designed to optimally screen for disease in general or LVSD in particular. The performance of the best retrospectively-validated A-ECG scores was then compared against that of optimized pooled criteria from the strictly conventional ECG in a test set of 315 additional individuals. Results Compared to optimized pooled criteria from the strictly conventional ECG, a 7-parameter A-ECG score validated in the training set increased the sensitivity of resting ECG for identifying disease in the test set from 78% (72-84%) to 92% (88-96%) (P < 0.0001) while also increasing specificity from 85% (77-91%) to 94% (88-98%) (P < 0.05). In diseased patients, another 5-parameter A-ECG score increased the PPV of ECG for LVSD from 53% (41-65%) to 92% (78-98%) (P < 0.0001) without compromising related negative predictive value. Conclusion Resting 12-lead A-ECG scoring is more accurate than strictly conventional ECG in screening for CAD, LVH and LVSD. |
| Databáze: | OpenAIRE |
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