title: Noninvasive mathematical analysis of spectral electrocardiographic components for coronary lesions of intermediate to obstructive stenosis severity-relationship with classic and functional SYNTAX score.
abstract: OBJECTIVE
  The aim of this study was to evaluate the relationship between the multifunction cardiogram (MCG), and SYNTAX score (SS) and functional SYNTAX score (FSS) in detecting the presence of intermediate to obstructive coronary lesions.
  
  
  BACKGROUND
  Performing coronary angiography (CAG) and measuring fractional flow reserve (FFR) to calculate the SS and FSS is inherently invasive and adds complexity.
  
  
  METHODS
  The MCG was obtained and analyzed before performing CAG in 87 consecutive subjects with suspected coronary artery disease who were scheduled for elective CAG. The patients were divided into three groups according to risk based on high, borderline, and low MCG scores. The SS was determined, as well as FSS but only by counting lesions prone to functional ischemia (FFR ≤ 0.8). The relationship between the MCG and the SS and FSS was evaluated.
  
  
  RESULTS
  The MCG was the only test significantly associated with the SS (odds ratio, 2.92 [1.60 - 5.31], P < 0.001) and FSS (odds ratio, 3.66 [1.95 - 6.87], P < 0.001). A high MCG score had a specificity of 92.6% (89.0-96.2%) and 92.3% (89.0-95.6%), and a predictive accuracy of 72.4% (67.6-77.2%) and 82.8% (78.7-86.8%) for the prediction of SS and FSS, respectively.
  
  
  CONCLUSIONS
  The MCG showed high specificity and predictive accuracy especially for the FSS, suggesting that it is useful not only in identifying functionally significant ischemia but also in reducing unnecessary CAGs.
authors.affiliation: Department of Cardiology, Aichi Medical University, Nagakute, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takeshita
authors.affiliation: Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Shinoda
authors.affiliation: Department of Cardiology, Aichi Medical University, Nagakute, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takashima
authors.affiliation: Department of Cardiology, Aichi Medical University, Nagakute, Japan.
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Kurita
authors.affiliation: Department of Cardiology, Aichi Medical University, Nagakute, Japan.
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Ando
authors.affiliation: Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Harada
authors.affiliation: Department of Cardiology, Chubu Rosai Hospital, Nagoya, Japan.
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Uetani
authors.affiliation: Advanced Medical Research Center, Aichi Medical University, Nagakute, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Gosho
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
authors.affiliation: Department of Cardiology, Aichi Medical University, Nagakute, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Amano
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology*; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index
keywords: fractional flow reserve; functional SYNTAX score; multifunction cardiogram