Ventricular gradient variability. New ECG method for detection of ischemic heart disease
S Horinaka1, H Yamamoto, T Tabuchi
1Department of Medicine, Dokkyo University School of Medicine, Tochigi, Japan.
Insights
Ventricular gradient variability, particularly in magnitude, effectively detects ischemic heart disease. This method shows high sensitivity and specificity for identifying coronary artery disease in patients.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Diagnostics
Background:
- Ischemic heart disease (IHD) diagnosis relies on various methods.
- Ventricular gradient analysis offers a potential non-invasive approach.
- Variability in ventricular gradient may indicate cardiac electrical instability.
Purpose of the Study:
- To evaluate the diagnostic utility of ventricular gradient variability for detecting ischemic heart disease.
- To compare variability indices between patients with coronary artery disease, chest pain, and healthy controls.
- To determine the most sensitive and specific index for identifying coronary artery disease.
Main Methods:
- Assessed ventricular gradient variability using standard deviation and coefficient of variation for azimuth, elevation, and magnitude.
- Analyzed 22-second resting heartbeats from 38 coronary artery disease patients, 21 chest pain patients, and 33 healthy controls.
- Defined normal limits based on 2 standard deviations above the control group mean.
Main Results:
- Ventricular gradient magnitude and elevation variability were significantly higher in the coronary artery disease group (P < .01).
- The coefficient of variation of ventricular gradient magnitude demonstrated 82% sensitivity and 91% specificity for coronary artery disease.
- This index proved superior in differentiating coronary artery disease from non-coronary artery disease chest pain.
Conclusions:
- Ventricular gradient magnitude variability is a reliable, sensitive, and specific index for diagnosing ischemic heart disease.
- This non-invasive technique can aid in the detection of coronary artery disease.
- Further research may establish ventricular gradient variability as a standard diagnostic tool.
Abstract:
The usefulness of ventricular gradient variability for detecting the presence of ischemic heart disease was evaluated in 38 patients with coronary artery disease (group 1), 21 patients with chest pain and no coronary artery disease (group 2), and 33 healthy control subjects. The ventricular gradient of each consecutive heartbeat at rest over a 22-second interval was calculated using a microcomputer. The SD and coefficient of variation for azimuth, elevation, and magnitude were used as indices of ventricular gradient variability. The SD and coefficient of variation of both the magnitude and elevation of ventricular gradient in group 1 were significantly greater than those of the other two groups (P < .01, respectively). When the normal upper limit was defined as 2SD above the mean value in the control group, a comparison between the findings for group 1 and group 2 revealed that the coefficient of variation of magnitude of the ventricular gradient was the most sensitive (82%) and specific (91%) index for coronary artery disease (chi-square test, P < .001). This study suggests that the variability in the magnitude of the ventricular gradient is a reliable index of ischemic heart disease.
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