New coronary artery disease index based on exercise-induced QRS changes

Area of Science:

• Cardiology
• Diagnostic Imaging
• Exercise Physiology

Background:

• Exercise-induced changes in Q, R, and S wave amplitudes have shown limited success in detecting coronary artery disease due to low specificity and sensitivity.
• A composite index incorporating these QRS wave changes may enhance diagnostic accuracy.

Purpose of the Study:

• To evaluate the diagnostic and prognostic utility of the Athens QRS score for coronary artery disease.
• To compare the Athens QRS score's performance against traditional exercise test parameters.

Main Methods:

• Retrospective and prospective analysis of 406 patients undergoing maximal exercise testing and coronary arteriography.
• Calculation of the Athens QRS score based on exercise-induced QRS complex amplitude changes.
• Correlation of the Athens QRS score with the number of obstructed coronary arteries and ST segment depression.

Main Results:

• The Athens QRS score decreased significantly with increasing coronary artery disease severity (p < 0.0001).
• Negative Athens QRS scores were consistently associated with coronary artery disease.
• An Athens QRS score of 5 mm demonstrated superior sensitivity (75-86%) and specificity (73-79%) for detecting coronary artery disease compared to individual QRS waves or ST segment depression.

Conclusions:

• Exercise-induced changes in the QRS complex, quantified by the Athens QRS score, offer a valuable tool for diagnosing coronary artery disease.
• The Athens QRS score can also aid in assessing the severity of coronary artery disease.