Related Experiment Videos
Cardiokymography during exercise testing: a new device for the detection of coronary artery disease and left
Insights
The cardiokymograph (CKG) accurately detects left ventricular wall motion abnormalities during exercise testing. This device improves the diagnosis of coronary artery disease (CAD) by serving as an additional marker for myocardial ischemia.
Area of Science:
- Cardiology
- Medical Devices
- Diagnostic Imaging
Background:
- The cardiokymograph (CKG) is a non-invasive device that assesses left ventricular (LV) wall motion.
- Exercise electrocardiogram (ECG) is a standard test for diagnosing coronary artery disease (CAD).
- Limitations exist in the diagnostic accuracy of exercise ECG for detecting CAD.
Purpose of the Study:
- To evaluate the accuracy of the cardiokymograph (CKG) in detecting coronary artery disease (CAD) during treadmill exercise testing.
- To compare the diagnostic performance of CKG with exercise ECG.
- To assess the utility of CKG as an additional marker for myocardial ischemia.
Main Methods:
- A prospective study involving 204 consecutive patients undergoing coronary arteriography.
- Exercise cardiokymography (CKG) and exercise electrocardiography (ECG) were performed.
- Correlation of CKG and ECG findings with coronary arteriography results and radionuclide ventriculography.
Main Results:
- The exercise CKG demonstrated higher sensitivity (73%) and specificity (95%) for CAD detection compared to exercise ECG (66% and 86%).
- Abnormal CKG findings were significantly more prevalent in patients with multi-vessel CAD and left anterior descending artery disease.
- CKG results correlated strongly with radionuclide ventriculography findings of impaired LV wall motion.
Conclusions:
- The cardiokymograph (CKG) accurately reflects left ventricular (LV) wall motion abnormalities during exercise.
- CKG can enhance the diagnostic accuracy of exercise testing for identifying myocardial ischemia and CAD.
- CKG shows promise as a valuable, non-invasive tool in the assessment of coronary artery disease.
Abstract:
The cardiokymograph (CKG) is a device that has been shown to reflect left ventricular (LV) wall motion abnormalities. Its accuracy in detecting coronary artery disease (CAD) during treadmill exercise testing was assessed in 204 consecutive patients undergoing coronary arteriography. Of the 188 patients with a technically adequate CKG, 146 (78%) had significant CAD. The sensitivity and specificity were similar for both the exercise electrocardiogram (ECG) (66% and 86%, respectively) and the exercise CKG (73% and 95%, respectively). An abnormal exercise CKG was significantly more common in patients with 3-vessel CAD than in those with 1-vessel disease (97% versus 52%, respectively; p less than 0.001) and in patients with left anterior descending disease than in those without (85% versus 26%, respectively; p less than 0.001). Seventy patients showed both an abnormal exercise ECG and CKG; all had CAD and 86% had multivessel CAD. Forty-eight patients demonstrated a normal exercise ECG and CKG; 29% had CAD but only 6% had multivessel CAD. Among 55 patients who had simultaneous exercise radionuclide ventriculography, new septal or apical wall motion abnormalities were found in 79% (23 of 29) of patients with an abnormal CKG compared with 19% (5 of 26) of patients with a normal CKG (p less than 0.001). Thus, the CKG during exercise testing accurately reflects LV wall motion abnormalities and can be used to improve the diagnostic accuracy of exercise testing as an additional marker of myocardial ischemia.