title: Correlation of nonlinear mathematical transformation of the normal electrocardiogram with the severity of coronary artery disease.
abstract: Signal processing was applied to normal ECGs to study whether the results could predict coronary artery disease (CAD) on angiography. ECGs determined to be normal by conventional criteria for 116 white males and 84 white females were subjected to signal processing. The technique applied nonlinear mathematical transformation to a segment of seven ECG leads which were photographically imaged, automatically digitized, normalized for time, and had topographical coordinate transformation using an IBM-XT microcomputer. The resulting curvilinear display on the computer monitor was termed a biopotential coordinate transformation (BCT). Successive superimposition of BCTs from normal ECGs of patients with normal angiograms developed boundaries of a normal template for each lead. Study BCTs were then compared to the normal templates to predict the presence or absence of CAD. Correlation of the BCT results with the severity of CAD for the males resulted in average sensitivities of 80%, 84.4%, and 91.7% for single, double, and triple-vessel CAD, respectively. Similarly, for the females average sensitivities were 59.1%, 73.9%, and 88.9%, respectively. In past studies on the same population, the BCT process detected CAD with average sensitivity of 85.1% and specificity of 81.8% for white males and average sensitivity of 73% and specificity 81% for white females. As such, computerized signal processing of ECGs may provide a noninvasive method for detection of CAD in patients with seemingly normal resting ECGs. The results of this study indicate that the sensitivity of the process increases in direct proportion to the severity of CAD. Further investigation is warranted for process refinement and verification.
authors.affiliation: Morristown Memorial Hospital, NJ.
authors.forename: D M
authors.initials: DM
authors.lastname: Schreck
authors.forename: T E
authors.initials: TE
authors.lastname: Terndrup
authors.forename: S F
authors.initials: SF
authors.lastname: Bosco
authors.forename: D
authors.initials: D
authors.lastname: Zacharias
authors.forename: L
authors.initials: L
authors.lastname: Ng
authors.forename: B S
authors.initials: BS
authors.lastname: Schreck
mesh_terms: D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D011336:Probability