title: Computer-enhanced frequency-domain and 12-lead electrocardiography accurately detect abnormalities consistent with obstructive and nonobstructive coronary artery disease.
abstract: Noninvasive methods of identifying coronary artery disease are not consistently accurate. To identify abnormalities associated with angiographically determined coronary artery disease, the authors sought to quantify the utility of a new device, a digital database-driven multiphase electrocardiograph system (3DMP), which produces a computer-enhanced frequency/time-domain resting electrocardiogram, in conjunction with a 12-lead electrocardiogram. The authors compared resting 3DMP results from those of coronary angiograms to identify abnormalities associated with coronary artery disease in a random sample of 136 patients. Using a discrete-Fourier transform signal-averaging variant and a series of mathematic transformations, the computer-expert system analyzed signals in the 0.1- to 50-Hz range. The system identified abnormalities by comparing results with a 21,000-patient database culled from predicate research. The system detected abnormalities in 96.0% of patients subsequently found to have 70% or greater stenosis by angiography. For patients with a 40% or less times a more than 50% occlusion, the system detected abnormalities in 75% of cases. For patients with a 50% or less times a 70% or less occlusion, it detected abnormalities in 90% of cases. Overall sensitivity for the study was 93.3% (positive predictive value, 91.2%; specificity, 83%; negative predictive value, 86.7%). No gender differences were detected. A 3DMP electrocardiograph system combined with 12-lead electrocardiography appears to have measurable, diagnostic utility in identifying 3DMP abnormalities associated with coronary artery disease, and warrants further study.
authors.affiliation: Division Of Cardiology, New York Medical College, Valhalla, New York, USA.
authors.forename: Melvin B
authors.initials: MB
authors.lastname: Weiss
authors.forename: S Murthy
authors.initials: SM
authors.lastname: Narasimhadevara
authors.forename: Gen Quan
authors.initials: GQ
authors.lastname: Feng
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Shen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis*; D003328:Coronary Thrombosis / Q000175:diagnosis; D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D004562:Electrocardiography / Q000295:instrumentation / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D005583:Fourier Analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index