Feasibility of Resting Multielectrode Electrocardiogram for Detecting Coronary Artery Disease.
Journal
Acta Cardiologica Sinica
Journal Volume
41
Journal Issue
6
Pages
731 - 743
ISSN
1011-6842
Date Issued
2025-11
Author(s)
Liu, Patrick Yan-Tyng
Lin, Lian-Yu
Harnod, Zeus
Lo, Men-Tzung
Wu, Chau-Chung
Abstract
Backgrounds: Myocardial ischemia can cause repolarization heterogeneity, manifesting as variations in QT interval; we hypothesized that repolarization heterogeneity could help identify patients with coronary artery disease (CAD). We tested this hypothesis by measuring repolarization heterogeneity with a newly developed multielectrode electrocardiogram (MECG) system, which uses 28 electrodes to increase the spatial resolution of body surface electrical activity. Methods and Results: Male patients admitted for coronary angiography were enrolled. Eighty-five patients were included in the training dataset, and 42 in the validation dataset. QTc heterogeneity indices including QTc dispersion (QTD) and smoothness index of QTc (SI-QTc) were derived from MECG signals. Sixty and 32 patients in the training and validation datasets, respectively, were found to have significant coronary stenosis. The SI-QTc (12.79 + 4.29 vs. 9.22 + 2.40 ms, p = 0.0004) and QTD (92.12 + 34.31 vs. 67.2 + 19.11 ms, p = 0.0004) of the patients in the training dataset were significantly higher in the CAD patients. The areas under the curve of SI-QTc and QTD in the training dataset were 0.7437 and 0.7433, respectively, for detecting CAD. With cutoff values of SI-QTc + 9.95 ms and QTc dispersion + 69 ms, the sensitivity and specificity for diagnosing CAD were 71.9% and 80.0%, respectively, in the validation dataset. Conclusion: Resting MECG is a promising noninvasive tool for CAD diagnosis, with sensitivity and specificity comparable to those of the exercise electrocardiography test.
Subjects
Coronary artery disease
Multielectrode electrocardiogram
QTc heterogeneity
Publisher
Republic of China Society of Cardiology
Type
journal article