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

Abstract

Background:Resting electrocardiogram (ECG) shows limited sensitivity and specificity for the detection of coronary artery disease (CAD). 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 423 patients without prior coronary revascularization 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: 3DMP identified 179 of 201 patients with hemodynamically relevant stenosis (sensitivity 89.1%, specificity 81.1%). The positive and negative predictive values for identification of coronary stenosis as diagnosed in coronary angiograms were 79% and 90% respectively. CAD risk factors in a logistic regression model had markedly lower predictive power for the presence of coronary stenosis in patients than did 3DMP severity score (odds ratio 3.35 [2.24-5.01] vs. 34.87 [20.00-60.79]). Logistic regression combining severity score with risk factors did not add significantly to the prediction quality (odds ratio 36.73 [20.92-64.51 ]).Conclusions: 3DMP's computer-based, mathematically derived analysis of resting two-lead ECG data provides detection of hemodynamically relevant CAD 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.

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

“…The overall sensitivity of 90.9% and specificity of 88% of the 3DMP device are in line with results from a study of 3DMP in patients with CAD but without previous revascularization done at the same center in parallel 22. Similar performance was also reported from another earlier study, although the results were based on a quantitative assessment of ischemia by the 3DMP system 21.…”

“…In contrast to the study in patients without previous revascularization from the same center there were no significant differences with respect to sensitivity or specificity attributable to gender or age 22. This may be due to selection effects, or just to the smaller sample size.…”

“…This is less than in patients without previous revascularization in the same setting investigated with the same methodology 22. But it is in concordance with large epidemiological studies, although these studies did not specifically investigate patients after coronary revascularization 14, 15, 16, 17.…”

Comparison of a Two-Lead, Computerized, Resting ECG Signal Analysis Device, the MultiFunction-CardioGramsm or MCG (a.k.a. 3DMP), to Quantitative Coronary Angiography for the Detection of Relevant Coronary Artery Stenosis (>70%) - A Meta-Analysis of all Published Trials Performed and Analyzed in the US

“…Further aspects of the underlying technology and methodology have been described elsewhere 20, 21, 22.…”

Noninvasive mathematical analysis of spectral electrocardiographic components for coronary lesions of intermediate to obstructive stenosis severity–relationship with classic and functional SYNTAX score

“…The MCG reports also indicate the level of myocardial damage and severity integrated into a score; other information such as coronary damage, area of damage, and myocardial pathological and pathophysiological conditions are included in the report. An MCG score of 4 was used as the cutoff score in most published clinical trials . In this study, we used the cut‐off score of 4 but investigated the scoring method further.…”