AI Article Synopsis
- Exercise electrocardiography (ECG) is important for diagnosing coronary artery disease (CAD), but its effectiveness in asymptomatic women requires further study; this research specifically analyzed ECG parameters in middle-aged women.
- The study included 108 asymptomatic women who completed exercise ECG tests multiple times, assessing false-positive rates of different ECG measures and their repeatability using statistical analyses.
- Results showed that a two-lead configuration reduced false-positive rates for certain ECG parameters, suggesting that ST/HR hysteresis and ST-segment recovery are more reliable indicators for diagnosing CAD than traditional methods.
Article Abstract
Background: Exercise electrocardiography (ECG) is a common diagnostic and prognostic method for the detection of coronary artery disease (CAD). However, its accuracy in asymptomatic women has not been comprehensively investigated and the diagnostic criteria may require refinements. This study evaluated the performance of ECG-derived ST/HR-index, ST/HR hysteresis and ST-segment depression parameters among asymptomatic middle-aged women.
Methods: 108 women (mean age 56 ± 4 years) performed exercise ECG test on treadmill until exhaustion three times within a nine-month period. False-positive rates of maximum ST/HR-index, ST/HR hysteresis, and ST-segment depression values measured from 12 leads at peak exercise and after one-minute recovery were evaluated with recommended diagnostic partition values. Repeatability was assessed with intraclass correlation (ICC) and Bland-Altman plot analysis.
Results: False-positive rate was lower for all variables when a two‑lead configuration was used instead of a single‑lead configuration. Using a two‑lead configuration, ST/HR hysteresis (0-1.9 %) and ST-segment depression after one-minute recovery (0-2.8 %) had lower false-positive rates compared to ST/HR index (3.7-20.4 %) and ST-segment depression at peak exercise (9.3-27.8 %). ICC values indicated moderate repeatability for ST/HR hysteresis while ST/HR index, ST-segment at peak exercise, and ST-segment after one-minute recovery had moderate-to-good repeatability. Bland-Altman analysis indicated poor repeatability for all evaluated ECG variables.
Conclusion: In asymptomatic middle-aged women, practitioners should prefer the use of ST/HR hysteresis and ST-segment after one-minute recovery over the conventional ST-segment depression at peak exercise or ST/HR index, and evaluate the ECG data from a two‑lead configuration instead of single‑lead.
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| http://dx.doi.org/10.1016/j.jelectrocard.2024.153820 | DOI Listing |
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Article Synopsis
- Exercise electrocardiography (ECG) is important for diagnosing coronary artery disease (CAD), but its effectiveness in asymptomatic women requires further study; this research specifically analyzed ECG parameters in middle-aged women.
- The study included 108 asymptomatic women who completed exercise ECG tests multiple times, assessing false-positive rates of different ECG measures and their repeatability using statistical analyses.
- Results showed that a two-lead configuration reduced false-positive rates for certain ECG parameters, suggesting that ST/HR hysteresis and ST-segment recovery are more reliable indicators for diagnosing CAD than traditional methods.
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