Use of Electrocardiographic Depolarization Abnormalities for Detection of Stress-Induced Ischemia as Defined by Myocardial Perfusion Imaging
High-frequency mid-QRS (HFQRS) analysis was recently introduced as a tool for identification of stress-induced ischemia. The diagnostic performance of this electrocardiographic technique has not been determined in a large cohort of patients. This study compared the diagnostic performance of HFQRS an...
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Veröffentlicht in: | The American journal of cardiology 2012-03, Vol.109 (5), p.642-650 |
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Format: | Artikel |
Sprache: | eng |
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Zusammenfassung: | High-frequency mid-QRS (HFQRS) analysis was recently introduced as a tool for identification of stress-induced ischemia. The diagnostic performance of this electrocardiographic technique has not been determined in a large cohort of patients. This study compared the diagnostic performance of HFQRS analysis to conventional ST-segment analysis in detecting exercise-induced ischemia. The study included 996 patients (56 ± 10 years of age, 670 men) referred for exercise myocardial perfusion imaging (MPI), which served as the gold standard of ischemia. High-resolution electrocardiogram was used for computer analysis of HFQRS signals. Number of electrocardiographic leads with ≥50% decrease of HFQRS intensity (L50% ) was used as an index of ischemia. Perfusion images were evaluated semiquantitatively. Receiver operating characteristic analysis demonstrated an L50% ≥3 as the criterion that yielded optimal sensitivity and specificity for diagnosing moderate/severe ischemia. Compared to ST-segment analysis HFQRS analysis was more sensitive (69% vs 39%, p |
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ISSN: | 0002-9149 1879-1913 |
DOI: | 10.1016/j.amjcard.2011.10.022 |