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The normal electrocardiogram as a predictor of left ventricular function in patients with coronary artery disease
Insights
Patients with coronary artery disease and normal electrocardiograms show preserved left ventricular function. A normal electrocardiogram does not correlate with the extent of coronary artery disease or predict ventricular asynergy.
Area of Science:
- Cardiology
- Cardiac Imaging
- Clinical Medicine
Background:
- Coronary artery disease (CAD) is a leading cause of mortality worldwide.
- Left ventricular (LV) function is a critical determinant of outcomes in CAD.
- Electrocardiogram (ECG) is a primary diagnostic tool, but its utility in assessing LV function in CAD requires further elucidation.
Purpose of the Study:
- To investigate the relationship between normal resting electrocardiograms (ECGs) and left ventricular (LV) function in patients with confirmed coronary artery disease.
- To determine if a normal ECG in CAD patients is associated with preserved LV function and to explore its correlation with the number of diseased coronary arteries.
Main Methods:
- Prospective study of 55 consecutive patients diagnosed with coronary artery disease.
- Assessment of left ventricular function, specifically looking for evidence of asynergy (abnormal wall motion).
- Correlation analysis between ECG findings, LV function, and the severity of coronary artery disease (number of affected vessels).
Main Results:
- 95% of patients with CAD and normal resting ECGs exhibited no evidence of left ventricular asynergy; only 3 patients showed mild hypokinesis.
- Significant left ventricular asynergy was not observed in the cohort with normal ECGs.
- A normal ECG finding was not associated with the number of coronary arteries involved in patients with CAD.
Conclusions:
- Normal resting electrocardiograms in patients with coronary artery disease are indicative of preserved left ventricular function.
- The absence of significant left ventricular asynergy is common in CAD patients with normal ECGs.
- ECG findings do not reliably predict the extent of coronary artery disease in terms of vessel involvement.
Abstract:
Fifty-five consecutive patients with a normal resting electrocardiogram and coronary artery disease were examined to determine left ventricular function. Fifty-two (95%) had no evidence of left ventricular asynergy; 3 patients had only mild hypokinesis. Of this group of patients, 25 (47%) had one vessel disease, 17 (30%) had two vessel disease, and 13 (23%) had three vessel disease. Significant left ventricular asynergy was not found in patients with coronary artery disease and normal electrocardiograms. In addition, a normal electrocardiogram was not related to the number of coronary arteries involved.