Document Detail

Variance ECG detection of coronary artery disease--a comparison with exercise stress test and myocardial scintigraphy.
MedLine Citation:
PMID:  8168281     Owner:  NLM     Status:  MEDLINE    
Variance electrocardiogram (ECG) is a newly developed method by which resting ECG is registered with 24 leads during 220 beats. The temporal beat-to-beat QRS microamplitude variability is computed and a nondimensional diagnostic variance ECG coronary artery disease (CAD) index is derived from it. Consecutive outpatients (n = 160) were referred to myocardial scintigraphy (SPECT) investigation for the evaluation of angina pectoris. The variance ECG CAD index was compared with a symptom-limited exercise stress test and SPECT during and after the exercise test and with coronary angiography (n = 67). Discriminant accuracy was tested with receiver-operating characteristics (ROC). Relative to angiographic coronary pathology (prevalence 0.85), diagnostic information for the variance ECG CAD index and for SPECT were both p < 0.001, while the outcome of the exercise stress test was non-contributory. Prevalence of persistent or transient perfusion defects at SPECT was 0.59. The exercise stress test had a diagnostic capacity of p < 0.01 for transient perfusion defects and variance ECG CAD index showed a high diagnostic performance (p < 0.001) for persistent perfusion defects. Overall pathology at SPECT was better (p < 0.05) identified by variance ECG CAD index than by symptom-limited exercise stress test. It was concluded that in this high prevalence population the variance ECG CAD index has a diagnostic capacity at least as good as that of SPECT and better than that of the exercise stress test. The variance ECG CAD index was strongly diagnostic for persistent perfusion defects while exercise stress test was slightly diagnostic for transient perfusion defects. Therefore, the two tests provide complementary diagnostic information.
C Sylvén; I Hagerman; M Ylén; O Nyquist; J Nowak
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical cardiology     Volume:  17     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  1994 Mar 
Date Detail:
Created Date:  1994-06-01     Completed Date:  1994-06-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  132-40     Citation Subset:  IM    
Karolinska Institute, Department of Clinical Physiology, Huddinge University Hospital, Sweden.
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MeSH Terms
Aged, 80 and over
Angina Pectoris / physiopathology
Coronary Angiography
Coronary Circulation / physiology
Coronary Disease / diagnosis*,  physiopathology,  radiography,  radionuclide imaging*
Electrocardiography / methods*
Exercise Test*
Middle Aged
Sensitivity and Specificity
Technetium Tc 99m Sestamibi / diagnostic use
Tomography, Emission-Computed, Single-Photon*
Reg. No./Substance:
109581-73-9/Technetium Tc 99m Sestamibi

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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