Datum: 21. Juli 2013 Kategorie: ,

Suitability of spatial orientation of the electrocardiologic T-loop for detecting coronary artery disease at rest

Cardiogoniometry (CGM) is a spatiotemporal electrocardiologic 5-lead method that utilizes automated analysis and may be useful for detecting coronary artery disease (CAD) at rest. Various multiparametric CGM methods for CAD detection have been presented. This paper aims to investigate the contribution of spatial orientation of the T-loop as sole CGM Parameter for detecting CAD. CGM data were collected in 793 consecutively admitted patients with presumed non-acute CAD prior to elective coronary angiography and analyzed retrospectively. 658 patients fulfilled the inclusion criteria, 405 had CAD verified by coronary angiography; the 253 patients with normal coronary angiograms served as the non-CAD controls. In all non-CAD patients, the mean spatial orientation of the T-loop was determined based on the longitude and latitude of the T-maximum vector. Normal fields shaped like rings were placed around this centric position. The hypothesis was that the majority of patients without CAD would be located within and the majority of patients with CAD outside these normal fields. The receiver operator characteristics (ROC) curve and different cut-off values were derived by enlarging the normal field using ascending radii around the centre point. The area under curve was 0.72. At a specificity of 72%, the sensitivity was 67% (comparable with stress ECG); at a specificity of 91%, the sensitivity was 38% (e.g. for screening examinations). The spatial orientation of the T-loop appears fundamental and suitable for detecting CAD. Prospective validation of these findings in clinical studies is ongoing.

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