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Construction and Use of Resting 12-Lead High Fidelity ECG "SuperScores" in Screening for Heart DiseaseWe investigated the accuracy of several conventional and advanced resting ECG parameters for identifying 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. Multiple conventional and advanced ECG parameters were studied for their individual and combined retrospective accuracies in detecting underlying disease, the advanced parameters falling within the following categories: 1) Signal averaged ECG, including 12-lead high frequency QRS (150-250 Hz) plus multiple filtered and unfiltered parameters from the derived Frank leads; 2) 12-lead P, QRS and T-wave morphology via singular value decomposition (SVD) plus signal averaging; 3) Multichannel (12-lead, derived Frank lead, SVD lead) beat-to-beat QT interval variability; 4) Spatial ventricular gradient (and gradient component) variability; and 5) Heart rate variability. Several multiparameter ECG SuperScores were derivable, using stepwise and then generalized additive logistic modeling, that each had 100% retrospective accuracy in detecting underlying CM or CAD. The performance of these same SuperScores was then prospectively evaluated using a test set of another 120 individuals (40 new individuals in each of the CM, CAD and control groups, respectively). All 12-lead ECG SuperScores retrospectively generated for CM continued to perform well in prospectively identifying CM (i.e., areas under the ROC curve greater than 0.95), with one such score (containing just 4 components) maintaining 100% prospective accuracy. SuperScores retrospectively generated for CAD performed somewhat less accurately, with prospective areas under the ROC curve typically in the 0.90-0.95 range. We conclude that resting 12-lead high-fidelity ECG employing and combining the results of several advanced ECG software techniques shows great promise as a rapid and inexpensive tool for screening of heart disease.
Document ID
20070022836
Acquisition Source
Johnson Space Center
Document Type
Conference Paper
Authors
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)
DePalma, J. L.
(Colorado State Univ. United States)
Starc, V.
(Ljubljana Univ. Ljubljana, Slovenia)
Nunez, T.
(Universidad de Los Andes Merida, Venezuela)
Medina, R.
(Universidad de Los Andes Merida, Venezuela)
Jugo, D.
(Universidad de Los Andes Merida, Venezuela)
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
September 30, 2007
Subject Category
Life Sciences (General)
Meeting Information
Meeting: Computers in Cardiology 2007
Location: Durham, NC
Country: United States
Start Date: September 30, 2007
End Date: October 3, 2007
Sponsors: Computers in Cardiology
Distribution Limits
Public
Copyright
Other

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