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Usefulness of Derived Frank Lead Parameters in Screening for Coronary Artery Disease and CardiomyopathyWe investigated the accuracy of several known as well as newly-introduced derived Frank-lead ECG parameters in differentiating healthy individuals from patients with obstructive coronary artery disease (CAD) and cardiomyopathy (CM). Advanced high-fidelity 12-lead ECG tests (approx. 5-min supine) were first performed on a "training set" of 99 individuals: 33 with ischemic or dilated CM and low ejection fraction (EF less than 40%); 33 with catheterization-proven obstructive CAD but normal EF; and 33 age-/gender-matched healthy controls. The following derived Frank lead parameters were studied for their accuracy in detecting CAD and CM: the spatial ventricular gradient (VG), including its beat-to-beat coefficient of variability (VG CV); the spatial mean QRS (SM-QRS) and T-waves (SM-T) and their beat-to-beat coefficients of variability; the spatial ventricular activation time (VAT); the mean and maximum spatial QRS-T angles; and standard late potentials parameters (RMS40, fQRSD and LAS). Several of these parameters were accurate in discriminating between the control group and both diseased groups at p less than 0.0001. For example the fQRSD, VG CV, mean spatial QRS-T angle and VG minus SM-QRS (which is similar to the SM-T) had retrospective areas under the ROC curve of 0.78, 0.78, 0.80, and 0.84 (CAD vs. controls) and 0.93, 0.88, 0.98 and 0.99 (CM vs. controls), respectively. The single most effective parameter in discriminating between the CAD and CM groups was the spatial VAT (44 plus or minus 5.8 vs. 53 plus or minus 9.9 ms, p less than 0.0001), with an area under the ROC curve of 0.80. Since subsequent prospective analyses using new groups of patients and healthy subjects have yielded only slightly less accurate results, we conclude that derived Frank-lead parameters show great promise for potentially contributing to the development of a rapid and inexpensive resting ECG-based screening test for heart disease.
Document ID
20070021582
Acquisition Source
Johnson Space Center
Document Type
Conference Paper
Authors
DePalma, J. L.
(Colorado State Univ. Pueblo, CO, United States)
Schlegel, T. T.
(NASA Johnson Space Center Houston, TX, United States)
Arenare, B.
(NASA Johnson Space Center Houston, TX, United States)
Greco, E. C.
(Arkansas Technical Univ. Russellville, AR, United States)
Starc, V.
(Ljubljana Univ. Ljubljana, Slovenia)
Rahman, M. A.
(Texas Univ. Houston, TX, United States)
Delgado, R.
(Texas Heart Inst. Houston, TX, United States)
Date Acquired
August 23, 2013
Publication Date
January 1, 2007
Subject Category
Life Sciences (General)
Meeting Information
Meeting: Computers in Cardiology
Location: Durhan, NC
Country: United States
Start Date: September 30, 2007
End Date: October 3, 2007
Sponsors: Duke Univ.
Distribution Limits
Public
Copyright
Other

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