SAECG in exercise test for prediction of diabetic coronary artery disease

• Authors: Mohammad Bigi , Amir Aslani , Arsalan Aslani
• Languages of publication: EN

Abstracts

EN

Signal averaged electrocardiogram (SAECG) is considered an important noninvasive indicator identifying patients at risk for ventricular arrhythmias. The aim of this study was to improve noninvasive prediction of CAD by integrating SAECG with the result of exercise tests in diabetic patients. Diabetic patients with stable angina pectoris underwent exercise testing and SAECG. Then a diagnostic score was derived that combined results of exercise testing and SAECG. A diagnostic score (0 to 2 points) was calculated by assigning 1 point for a positive exercise test result and 1 point for a positive SAECG. One hundred and seventy patients were included in the study. In patients with a score of 0, the likelihood of CAD is 18% whereas the likelihood of CAD is 95% in patients with a score of 2. Triple vessel CAD is present in 54%, 7% and only 1.5% of patients with score 2, 1 and 0 respectively. Therefore, patients with score 2 have a poor prognosis compared with score 1 or 0. A diagnostic score combining exercise testing and SAECG can distinguish patients with CAD from those without CAD with high accuracy in diabetic patients.

Keywords

EN

Coronary artery disease; Diabetes; Exercise testing; Signal average electrocardiogram

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2010
• Volume: 5
• Issue: 3
• Pages: 298-302

Dates

published

1 - 6 - 2010

online

9 - 4 - 2010

Contributors

author

Mohammad Bigi

• Cardiology Department, Shiraz University of Medical Sciences, 71935-1334, Shiraz, Iran

author

Amir Aslani

• Cardiology Department, Shiraz University of Medical Sciences, 71935-1334, Shiraz, Iran

author

Arsalan Aslani

• Cardiology Department, Shiraz University of Medical Sciences, 71935-1334, Shiraz, Iran

References

• [1] G. Ravapati, W.S. Aronow, C. Ahn, K. Sujata, L.N. Saulle and M.B. Weiss, Association of hemoglobin A1c level with the severity of coronary artery disease in patients with diabetes mellitus. Am J Cardiol 2006; 97: 968–969 http://dx.doi.org/10.1016/j.amjcard.2005.10.039[Crossref]
• [2] G. Ndrepepa, S. Braun, J. Mehilli, N. von Beckerath, W. Vogt, A. Schomig and A. Kastrati, Plasma levels of N-terminal pro-brain natriuretic peptide in patients with coronary artery disease and relation to clinical presentation, angiographic severity, and left ventricular ejection fraction. Am J Cardiol 2005; 95: 553–557 http://dx.doi.org/10.1016/j.amjcard.2004.10.034[Crossref]
• [3] M. Weber, T. Dill, R. Arnold, M. Rau, O. Ekinci, K.D. Muller, A. Berkovitsch, V. Mitrovic and C. Hamm, N-terminal B-type natriuretic peptide predicts extent ofcoronary artery disease and ischemia in patients with stable angina pectoris. Am Heart J 2004; 148: 612–620 http://dx.doi.org/10.1016/j.ahj.2004.04.021[Crossref]
• [4] Buxton AE, Simson MB, Falcone RA, Marchlinski FE, Doherty JU, Josephson ME. Results of signal-averaged electrocardiography and electrophysiologic study in patients with nonsustained ventricular tachycardia after healing of acute myocardial infarction. Am J Cardiol 1987; 60: 80–85 http://dx.doi.org/10.1016/0002-9149(87)90989-1[Crossref]
• [5] Vassallo JA, Cassidy D, Simson MB, Buxton AE, Marchlinski FE, Josephson ME. Relation of late potentials to site of origin of ventricular tachycardia associated with coronary heart disease. Am J Cardiol 1985; 55: 985–989 http://dx.doi.org/10.1016/0002-9149(85)90731-3[Crossref]
• [6] Freedman RA, Gillis AM, Keren A, Soderholm-Difatte V, Mason JW. Signal-averaged electrocardiographic late potentials in patients with ventricular fibrillation or ventricular tachycardia: correlation with clinical arrhythmia and electrophysiologic study. Am J Cardiol 1985; 55:1350–1353 http://dx.doi.org/10.1016/0002-9149(85)90502-8[Crossref]
• [7] The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997; 20:1183–1197
• [8] E.L. Conover, Signal-averaged ECG and fast Fourier transform analysis. In: M.B. Conover, Editor, Understanding Electrocardiography (8th ed.), Mosby, St. Louis, Missouri (2003), 447–454
• [9] G. Breithardt, M.E. Cain, N. El-Sherif, N.C. Flowers, V. Hombach, M. Janse, M.B. Simson and G. Steinbeck, Standards of analysis of late potentials using high-resolution or signal-averaged electrocardiography: a statement by a task force committee of the European Society of Cardiology, the American Heart Association, and the American College of Cardiology. J Am Coll Cardiol 1991; 17: 999–1006 http://dx.doi.org/10.1016/0735-1097(91)90822-Q[Crossref]
• [10] K.A. Gatzoulis, L.A. Carlson, B.I. Rizos, P. Gialafos, P. Toutouzas and A.L. Waldo, Time domain analysis of the signal averaged electrocardiogram in patients with a conduction defect of a bundle branch block. Eur Heart J 1995; 16: 1912–1919
• [11] A.S. Manolis, J.A. Chiladakis, J.S. Malakos, V. Vassilikos, T. Maonis and C.V. Cokkinos, Abnormal signal averaged electrocardiograms in patients with incomplete right bundle branch block. Clin Cardiol 1997; 20: 17–22 http://dx.doi.org/10.1002/clc.4960200106[Crossref]
• [12] Denes P, Uretz E, Santarelli P. Determinants of arrhythmogenic ventricular activity detected on the body surface QRS in patients with coronary artery disease. Am J Cardiol 1984; 53: 1519–1523 http://dx.doi.org/10.1016/0002-9149(84)90571-X[Crossref]
• [13] Myerburg RJ, Epstein K, Gaide MS, Wong SS, Castellanos A, Gelband H, Bassett AL. Electrophysiologic consequences of experimental acute ischemia superimposed on healed myocardial infarction in cats. Am J Cardiol 1982; 49: 323–330 http://dx.doi.org/10.1016/0002-9149(82)90508-2[Crossref]
• [14] Myerburg RJ, Kessler KM, Castellanos A. Pathophysiology of sudden cardiac death. Pacing Clin Electrophysiol 1991; 14: 935–943 http://dx.doi.org/10.1111/j.1540-8159.1991.tb04138.x[Crossref]
• [15] Robertson WS, Feigenbaum H, Armstrong WF, Dillon JC, O’Donnell J, McHenry PW. Exercise echocardiography: a clinically practical addition in the evaluation of coronary artery disease. J Am Coll Cardiol 1983; 2: 1085–1091 http://dx.doi.org/10.1016/S0735-1097(83)80334-9[Crossref]
• [16] McPherson DD, Horacek BM, Sutherland DJ, Armstrong CS, Spencer CA, Montague TJ. Exercise electrocardiographic mapping in normal subjects. J Electrocardiol 1985; 18: 351–360 http://dx.doi.org/10.1016/S0022-0736(85)80017-0[Crossref]

Identifiers

DOI

10.2478/s11536-009-0124-4