Portable-type signal-averaged electrocardiography with dipyridamole to detect patients with coronary artery disease.
BACKGROUND
In a retrospective study portable-type signal-averaged electrocardiography (SAECG) with dipyridamole stress was found to identify patients with coronary artery disease (CAD) at their bedside with high sensitivity and specificity, so the utility of this method was prospectively investigated in the present study.


RESULTS
Standard 12-lead QRS wave SAECG was performed before and after dipyridamole stress at the bedside in 71 patients with chest pain (43 males, mean age 63 +/-9 years). The filtered QRS duration (fQRSd) before and after dipyridamole stress was determined by multiphasic oscillation method for each of the standard 12 leads, and the maximal value of changes in fQRSd (MAX DeltafQRSd) among the 12 leads was determined. The positive test was defined as MAX DeltafQRSd >or=5 ms, and negative as MAX DeltafQRSd <5 ms based on the previous study. Selective coronary arteriography was performed next. In the positive group (n=31), 25 patients had significant stenosis of the coronary artery and 6 did not. In the negative group (n=40), 5 patients had significant stenosis and 35 did not. The sensitivity, specificity, positive predictive accuracy and negative predictive accuracy for CAD detection by SAECG was 83%, 85%, 81% and 88%, respectively.


CONCLUSIONS
Dipyridamole-stress portable SAECG is useful for detecting CAD at the patient's bedside with high sensitivity and specificity.
Otsubo
Hitoshi
H
Department of Internal Medicine, Division of Cardio-Vascular Medicine and Cardiovascular Research Institute, Kurume University School of Medicine, Kurume, Japan.
Yoshida
Teruhisa
T
Hiraki
Tatsuro
T
Inage
Tomohito
T
Matsumoto
Manabu
M
Imaizumi
Tsutomu
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis*; D004176:Dipyridamole; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010726:Phosphodiesterase Inhibitors; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D010726:Phosphodiesterase Inhibitors; D004176:Dipyridamole