UMM Logo

Universitas Muhammadiyah Malang


Free Download Journals Directory


International Journal of Medical Sciences

.: Home > International Journal of Medical Sciences > 2008 > Volume 5 Number 2 > Eberhard Grube1, Andreas Bootsveld2, Lutz Buellesfeld1, Seyrani Yuecel1, Joseph T Shen3, Michael Imhoff4

Computerized two-lead resting ECG analysis for the detection of coronary artery stenosis after coronary revascularization

Eberhard Grube1, Andreas Bootsveld2, Lutz Buellesfeld1, Seyrani Yuecel1, Joseph T Shen3, Michael Imhoff4
1. Department of Cardiology and Angiology, HELIOS Heart Center Siegburg, Siegburg, Germany 2. Department of Cardiology, Evangelisches Stift St. Martin, Koblenz, Germany 3. Premier Heart, LLC, Port Washington, NY, USA 4. Department for Medical Informatics, Biometrics and Epidemiology, Ruhr-University Bochum, Bochum, Germany
Abstract :

Background: Resting electrocardiogram (ECG) shows limited sensitivity and specificity for the detection of coronary artery disease (CAD), where patients with a history of coronary revascularization may pose special challenges. Several methods exist to enhance sensitivity and specificity of resting ECG for diagnosis of CAD, but such methods are not better than a specialist’s judgement. We compared a new computer-enhanced, resting ECG analysis device, 3DMP, to coronary angiography to evaluate the device’s accuracy in detecting hemodynamically relevant CAD. Methods: A convenience sample of 172 patients with a history of coronary revascularization scheduled for coronary angiography was evaluated with 3DMP before coronary angiography. 3DMP's sensitivity and specificity in detecting   hemodynamically relevant coronary stenosis as diagnosed with coronary angiography were calculated as well as odds ratios for the 3DMP severity score and coronary artery disease risk factors. Results: The 3DMP system accurately identified 50 of 55 patients as having hemodynamically relevant stenosis
(sensitivity 90.9%, specificity 88.0%). Positive and negative predictive values for the identification of coronary stenosis as diagnosed in coronary angiograms were 62.7% and 97.8% respectively. Risk and demographic factors in a logistic regression model had a markedly lower predictive power for the presence of coronary stenosis in these patients than did 3DMP severity score (odds ratio 2.04 [0.74-5.62] vs. 73.57 [25.10-215.68]). A logistic regression combining severity score with risk and demographic factors did not add significantly to the prediction quality (odds ratio 80.00 [27.03-236.79]).
Conclusions: 3DMP’s computer-based, mathematically derived analysis of resting two-lead ECG data provides detection of hemodynamically relevant CAD in patients with a history of coronary  revascularization with high sensitivity and specificity that appears to be at least as good as those reported for other resting and/or stress ECG methods currently used in clinical practice.

Keywords :
coronary artery disease, electrocardiography, computer-enhanced, coronary imaging: angiography, sensitivity, specificity, post-intervention

Date Deposited : 28 Jul 2011 10:30

Last Modified : 28 Jul 2011 10:30

Official URL: http://www.medsci.org/archive

Volume 5, Number 2, - 2008 , ISSN 1449-1907

Download:
Full Text Original
Abstract : pdf doc
Home | Peta Situs | Admissions | Student Research | E-Journal
Universitas Muhammadiyah Malang © 2011
Developed by Infokom UMM
Last Update : 13 December 2016 20:46Kumpulan file jurnal