Long Liu MM, Xinyue Du MM, Xue Wei MM, Wei Dong MB, Hong Lu MM, Guishen Jiang MM, Guolan Deng MM
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Before angiography, patients underwent exercise stress testing utilizing an upright bicycle. High-resolution electrocardiogram (ECG) data were collected during the exercise test, facilitating both HF-QRS and conventional ST-segment analyses. The diagnostic efficacy of HF-QRS and ST-segment analysis were compared, utilizing angiographic outcomes as the gold standard. The study design integrated HF-QRS analysis and ST-segment analysis via sequential and concurrent testing protocols.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>In terms of CAD detection, HF-QRS analysis displayed superior sensitivity compared to conventional ST-segment analysis (63% vs. 37%, <i>p</i> = .002). The serial test significantly increased specificity from 79% to 97% (<i>p</i> = .002) compared to ST-deviation analysis alone. It showed a markedly low sensitivity of 26%. The parallel test significantly increased sensitivity from 37% to 77% (<i>p</i> < .001), while retaining a moderate level of specificity of 51%. The quantity of ECG leads exhibiting a positive HF-QRS response demonstrated a correlation with the severity of CAD (<i>p</i> < .001).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>HF-QRS analysis exhibited superior sensitivity in detecting angiographically confirmed CAD relative to conventional ST-segment analysis. Moreover, the combination of HF-QRS and ST-segment alterations during exercise stress test enhanced the diagnostic efficacy for CAD.</p>\n </section>\n </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"47 3","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.24254","citationCount":"0","resultStr":"{\"title\":\"The combination of high-frequency QRS and ST-segment alterations during exercise stress tests enhanced the diagnostic efficacy for coronary artery disease\",\"authors\":\"Long Liu MM, Xinyue Du MM, Xue Wei MM, Wei Dong MB, Hong Lu MM, Guishen Jiang MM, Guolan Deng MM\",\"doi\":\"10.1002/clc.24254\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>High-frequency QRS (HF-QRS) manifests as a novel adjunct electrocardiographic marker with potential utility in coronary artery disease (CAD) detection.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Hypothesis</h3>\\n \\n <p>We hypothesize that HF-QRS analysis may be superior to conventional ST-segment analysis in detecting CAD, and the combination of these two analyses in the exercise stress test may enhance the diagnostic efficacy for CAD.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>The study incorporated a sample of 157 patients (mean age 62 <math>\\n <semantics>\\n <mrow>\\n <mo>±</mo>\\n </mrow>\\n <annotation> $\\\\pm $</annotation>\\n </semantics></math> 9 years) referred for nonemergent angiography. 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引用次数: 0
摘要
背景:高频 QRS(HF-QRS)是一种新型的辅助心电图标记,在冠状动脉疾病(CAD)检测中具有潜在作用:我们假设,在检测 CAD 方面,HF-QRS 分析可能优于传统的 ST 段分析,在运动负荷试验中结合这两种分析可能会提高 CAD 的诊断效果:研究纳入了157名转诊为非急诊血管造影术的患者样本(平均年龄62 ± $\pm $ 9岁)。血管造影术前,患者使用直立自行车进行运动负荷测试。在运动测试过程中收集了高分辨率心电图(ECG)数据,为HF-QRS和传统ST段分析提供了便利。以血管造影结果为金标准,比较了 HF-QRS 和 ST 段分析的诊断效果。研究设计通过顺序和并行测试方案将高频-心动周期分析和 ST 段分析结合在一起:结果:就 CAD 检测而言,HF-QRS 分析的灵敏度高于传统的 ST 段分析(63% 对 37%,P = .002)。与单纯的 ST 差分析相比,连续测试的特异性从 79% 明显提高到 97%(p = .002)。但其敏感性明显较低,仅为 26%。平行测试将灵敏度从 37% 大幅提高到 77%(P = 0.002):与传统的 ST 段分析相比,HF-QRS 分析在检测血管造影证实的 CAD 方面表现出更高的灵敏度。此外,在运动负荷试验中结合使用 HF-QRS 和 ST 段改变可提高对 CAD 的诊断效果。
The combination of high-frequency QRS and ST-segment alterations during exercise stress tests enhanced the diagnostic efficacy for coronary artery disease
Background
High-frequency QRS (HF-QRS) manifests as a novel adjunct electrocardiographic marker with potential utility in coronary artery disease (CAD) detection.
Hypothesis
We hypothesize that HF-QRS analysis may be superior to conventional ST-segment analysis in detecting CAD, and the combination of these two analyses in the exercise stress test may enhance the diagnostic efficacy for CAD.
Methods
The study incorporated a sample of 157 patients (mean age 62 9 years) referred for nonemergent angiography. Before angiography, patients underwent exercise stress testing utilizing an upright bicycle. High-resolution electrocardiogram (ECG) data were collected during the exercise test, facilitating both HF-QRS and conventional ST-segment analyses. The diagnostic efficacy of HF-QRS and ST-segment analysis were compared, utilizing angiographic outcomes as the gold standard. The study design integrated HF-QRS analysis and ST-segment analysis via sequential and concurrent testing protocols.
Results
In terms of CAD detection, HF-QRS analysis displayed superior sensitivity compared to conventional ST-segment analysis (63% vs. 37%, p = .002). The serial test significantly increased specificity from 79% to 97% (p = .002) compared to ST-deviation analysis alone. It showed a markedly low sensitivity of 26%. The parallel test significantly increased sensitivity from 37% to 77% (p < .001), while retaining a moderate level of specificity of 51%. The quantity of ECG leads exhibiting a positive HF-QRS response demonstrated a correlation with the severity of CAD (p < .001).
Conclusions
HF-QRS analysis exhibited superior sensitivity in detecting angiographically confirmed CAD relative to conventional ST-segment analysis. Moreover, the combination of HF-QRS and ST-segment alterations during exercise stress test enhanced the diagnostic efficacy for CAD.
期刊介绍:
Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery.
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