A new non-invasive detector for coronary microvascular dysfunction: exercise stress high-frequency QRS...

Area of Science:

• Cardiology
• Diagnostic Imaging
• Noninvasive Cardiovascular Testing

Background:

• Coronary microvascular dysfunction (CMVD) diagnosis remains challenging.
• Evaluating noninvasive markers for CMVD is crucial for patient management.

Purpose of the Study:

• To assess the diagnostic utility of exercise stress high-frequency QRS (HFQRS) electrocardiogram for CMVD.
• To determine the correlation between HFQRS findings and coronary microvascular resistance.

Main Methods:

• 139 patients with chest pain underwent exercise HFQRS and coronary angiography.
• Coronary angiography-based microvascular resistance (caIMR) served as the gold standard.
• Sensitivity, specificity, and ROC curve analysis were used to evaluate HFQRS performance.

Main Results:

• A significant correlation (R=0.757) was found between caIMR and the number of positive HFQRS leads.
• Positive HFQRS leads independently predicted caIMR (OR 9.17).
• The area under the ROC curve for HFQRS prediction was 0.81, with high specificity (0.971) and NPV (0.986).

Conclusions:

• Exercise HFQRS is a valuable, noninvasive predictor of coronary microvascular disease.
• The number of positive exercise HFQRS leads correlates with CMVD severity.
• Exercise stress HFQRS offers a reliable diagnostic approach for CMVD.