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A Novel ECG Score for Predicting Left Ventricular Systolic Dysfunction in Stable Angina: A Pilot Study.

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Summary

A new composite electrocardiogram (ECG) score effectively detects left ventricular systolic dysfunction (LVSD) in stable angina patients. This simple ECG score aids in early risk stratification for patients with ischemic heart disease.

Keywords:
R-wave peak timecoronary artery diseaseelectrocardiographyfragmented QRSleft ventricular systolic dysfunctionstable angina pectoris

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Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Biomedical Engineering

Background:

  • Left ventricular systolic dysfunction (LVSD) significantly impacts prognosis in ischemic heart disease patients.
  • Electrocardiography (ECG) is a readily accessible tool for risk assessment.
  • This study investigated if a composite ECG score could enhance LVSD detection in stable angina.

Purpose of the Study:

  • To develop and validate a composite ECG score for detecting LVSD in patients with stable angina.
  • To assess the score's ability to identify patients needing further cardiac imaging.

Main Methods:

  • 177 stable angina patients undergoing coronary angiography were analyzed.
  • ECG parameters (fragmented QRS, Q waves, R-wave peak time, QRS duration, QRS-T angle) were assessed.
  • A composite score was created, and its association with LVSD (defined by echocardiography) was evaluated using logistic regression, ROC analysis, and cross-validation.

Main Results:

  • Independent predictors of LVSD included prior stent, fragmented QRS, pathological Q waves, R-wave peak time, QRS duration, and frontal QRS-T angle.
  • The composite ECG score demonstrated strong performance: a score ≥2 showed high sensitivity (88%) and NPV (97%); a score ≥3 showed high specificity (100%) and PPV (100%).
  • Model validation confirmed stability and high discriminatory performance (AUC 0.964, accuracy 0.91).

Conclusions:

  • A composite ECG score integrating multiple markers robustly detects LVSD in stable angina patients.
  • This score can aid in early risk stratification and identify patients for further evaluation.
  • External validation is needed for routine clinical use.