The combination of high-frequency QRS and ST-segment alterations during exercise stress tests enhanced the diagnostic efficacy for coronary artery disease

作者全名："Liu, Long; Du, Xinyue; Wei, Xue; Dong, Wei; Lu, Hong; Jiang, Guishen; Deng, Guolan"

作者地址："[Liu, Long; Wei, Xue; Lu, Hong; Jiang, Guishen] Chongqing Med Univ, Clin Coll 1, Chongqing, Peoples R China; [Du, Xinyue; Deng, Guolan] Chongqing Med Univ, Cardiovasc Med Dept, Affiliated Hosp 1, Chongqing, Peoples R China; [Dong, Wei] Zunyi Med Univ, Sch Med Imaging, Zunyi, Guizhou, Peoples R China"

通信作者："Deng, GL (通讯作者)，Chongqing Med Univ, Cardiovasc Med Dept, Affiliated Hosp 1, Chongqing, Peoples R China."

来源：CLINICAL CARDIOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001183655400001

JCR分区：Q2

影响因子：2.7

年份：2024

卷号：47

期号：3

开始页：　

结束页：　

文献类型：Article

关键词：coronary artery disease; electrocardiogram; exercise stress test; high-frequency QRS

摘要："Background High-frequency QRS (HF-QRS) manifests as a novel adjunct electrocardiographic marker with potential utility in coronary artery disease (CAD) detection. HypothesisWe 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."

基金机构：Chongqing Science and Technology Bureau

基金资助正文：Chongqing Science and Technology Bureau