Evaluation of the possibility of using spectral analysis of a single-channel ECG for the diagnosis of diastolic dysfunction of the left ventricle of the heart

Abstract

Objective: Assessment of diastolic function of the left ventricle (LVDF) makes it possible to detect chronic heart failure (CHF) at the preclinical stage of development, when its progression can still be prevented. Doppler echocardiography (echo) is the most accurate non-invasive diagnostic method for left ventricular diastolic dysfunction (LVDD), requiring expensive equipment and trained professionals. The development of an accessible screening method for the diagnosis of LVDD is an urgent and practically significant task. Purpose of the study was to evaluate the diagnostic value, sensitivity and specificity, positive predictive value and negative predictive value of the method of spectral analysis of a single-channel electrocardiogram (S-ch ECG) proposed by us for the diagnosis of LVDD in comparison with Doppler echo as a reference. Methods: The study involved 60 people (35 patients on program hemodialysis with arterial hypertension and 25 healthy individuals). Among the patients there were 19 men and 16 women aged 29 to 65 (45.9 (12.8)) years. Among the healthy were 15 men and 10 women aged 25 to 63 (43.2(11.8)). Doppler echo was performed on the SonoSite Micro Maxx Belse X2 apparatus. LVDF was determined according to the generally accepted method. S-ch ECG was taken with portable recorder DuoEK 118 from Lepu Medical. LVDD was determined by S-ch ECG spectral analysis as the ratio of the sum of harmonic power in the period of early diastolic filling to the sum of harmonic power during the period of atrial contraction. Results: The sensitivity of the method developed by us was 0.74, and the specificity was 0.84. Positive predictive value was 0.87 and negative predictive value was 0.70. Chi-square: 15.043, p<0.0001 - the presence of a relationship is statistically highly significant; Phi=0.514, p<0.0001 - the presence of a connection is highly significant. Area Under the Curve is 0.791 (0.061) with a confidence interval of 0.672 to 0.911. The obtained values indicate that S-ch ECG scores are fairly good predictors of LVDD. Conclusion: Spectral analysis of S-ch ECG has a high sensitivity and sufficient specificity for the diagnosis of LVDD. This method can be used for remote mass screening studies for the purpose of preclinical diagnosis of CHF.