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Identifying Patients With Coronary Artery Disease Using Rest and Exercise Seismocardiography
Parastoo Dehkordi1, Erwin P Bauer2, Kouhyar Tavakolian3,4
1Electrical and Computer Engineering Department, Biomedical Department, The University of British Columbia, Vancouver, BC, Canada.
Insights
Seismocardiography (SCG), a non-invasive method, shows promise in identifying coronary artery disease (CAD). The exercise SCG model achieved 81% accuracy, outperforming traditional stress-ECG.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Diagnostics
Background:
- Coronary artery disease (CAD) is a leading global cause of mortality.
- Current diagnostic methods for suspected CAD include exercise electrocardiography (ECG), coronary angiography, and coronary computed tomography angiography (CCTA).
- These methods aim to detect and quantify arterial blockages.
Purpose of the Study:
- To introduce and evaluate a novel, non-invasive methodology for identifying patients with CAD.
- To assess the diagnostic performance of seismocardiography (SCG) signals recorded at rest and during post-exercise states.
- To compare the efficacy of SCG-based models against traditional diagnostic standards.
Main Methods:
- SCG signals, measuring chest accelerations from myocardial motion, were recorded from 185 individuals at rest and immediately after exercise.
- Two diagnostic models were developed based on the characterization of rest and exercise SCG signals.
- Model performance was validated against coronary angiography results.
Main Results:
- The exercise SCG model demonstrated higher diagnostic accuracy (81%) compared to the rest model (74%).
- Sensitivity and specificity for the exercise model were 82% and 84%, respectively.
- The exercise SCG model showed a superior area under the curve (0.91) compared to the rest model (0.77), indicating better discrimination.
Conclusions:
- Both rest and exercise SCG models effectively identify CAD with comparable accuracy, sensitivity, and specificity.
- SCG performance is superior to stress-ECG and comparable to stress-echocardiography and CCTA.
- SCG offers a fast, inexpensive, and potentially layperson-administrable alternative for CAD detection.
Abstract:
Coronary artery disease (CAD) is the most common cause of death globally. Patients with suspected CAD are usually assessed by exercise electrocardiography (ECG). Subsequent tests, such as coronary angiography and coronary computed tomography angiography (CCTA) are performed to localize the stenosis and to estimate the degree of blockage. The present study describes a non-invasive methodology to identify patients with CAD based on the analysis of both rest and exercise seismocardiography (SCG). SCG is a non-invasive technology for capturing the acceleration of the chest induced by myocardial motion and vibrations. SCG signals were recorded from 185 individuals at rest and immediately after exercise. Two models were developed using the characterization of the rest and exercise SCG signals to identify individuals with CAD. The models were validated against related results from angiography. For the rest model, accuracy was 74%, and sensitivity and specificity were estimated as 75 and 72%, respectively. For the exercise model accuracy, sensitivity, and specificity were 81, 82, and 84%, respectively. The rest and exercise models presented a bootstrap-corrected area under the curve of 0.77 and 0.91, respectively. The discrimination slope was estimated 0.32 for rest model and 0.47 for the exercise model. The difference between the discrimination slopes of these two models was 0.15 (95% CI: 0.10 to 0.23, p < 0.0001). Both rest and exercise models are able to detect CAD with comparable accuracy, sensitivity, and specificity. Performance of SCG is better compared to stress-ECG and it is identical to stress-echocardiography and CCTA. SCG examination is fast, inexpensive, and may even be carried out by laypersons.
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