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

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.