Michel Zuber1, Paul Erne. 1. Michel Zuber, Paul Erne, Division of Cardiology, Luzerner Kantonsspital, Lucerne, Kantonsspital, CH-6000 Luzern 16, Switzerland.
Abstract
AIM: To assess if performance of 12-lead exercise tolerance testing (ETT) can be improved by simultaneous acoustic cardiography and to compare the diagnostic performances of electrocardiography (ECG) during ETT and acoustic cardiography for detection or exclusion of angiographically proven coronary artery disease (CAD). METHODS: We conducted an explorative study with retrospective data analysis using a convenience sample of consecutive patients (n = 59, mean age: 62 years) from an outpatient clinic in Switzerland, who were referred for ETT by their general practitioner on suspicion of CAD, and in whom, coronary angiography was carried out. Measurements included sensitivity, specificity, likelihood ratios and receiver operating characteristic curves. A standard, symptom-limited, 12-lead ECG exercise tolerance test was performed by independent persons with simultaneous acoustic cardiography and subsequent cardiac angiography for determination of significant CAD. RESULTS: Thirty-four of the 59 adult subjects (58%) had a final diagnosis of CAD by angiography, and in 25 subjects, CAD was excluded by angiography. Sensitivity/specificity of ST segment depression in the group was 29%/92%, whereas the most powerful acoustic cardiographic parameter was the strength of the fourth heart sound (S4), with corresponding sensitivity/specificity of 53%/92%. The disjunctive combination of the S4 and ST depression had sensitivity/specificity of 68%/84%. CONCLUSION: In this preliminary pilot study, the use of acoustic cardiography alone during ETT or disjunctively with ST depression has been shown to be a simple and convenient method for the detection of CAD, which was superior to ST depression on the standardized ECG.
AIM: To assess if performance of 12-lead exercise tolerance testing (ETT) can be improved by simultaneous acoustic cardiography and to compare the diagnostic performances of electrocardiography (ECG) during ETT and acoustic cardiography for detection or exclusion of angiographically proven coronary artery disease (CAD). METHODS: We conducted an explorative study with retrospective data analysis using a convenience sample of consecutive patients (n = 59, mean age: 62 years) from an outpatient clinic in Switzerland, who were referred for ETT by their general practitioner on suspicion of CAD, and in whom, coronary angiography was carried out. Measurements included sensitivity, specificity, likelihood ratios and receiver operating characteristic curves. A standard, symptom-limited, 12-lead ECG exercise tolerance test was performed by independent persons with simultaneous acoustic cardiography and subsequent cardiac angiography for determination of significant CAD. RESULTS: Thirty-four of the 59 adult subjects (58%) had a final diagnosis of CAD by angiography, and in 25 subjects, CAD was excluded by angiography. Sensitivity/specificity of ST segment depression in the group was 29%/92%, whereas the most powerful acoustic cardiographic parameter was the strength of the fourth heart sound (S4), with corresponding sensitivity/specificity of 53%/92%. The disjunctive combination of the S4 and ST depression had sensitivity/specificity of 68%/84%. CONCLUSION: In this preliminary pilot study, the use of acoustic cardiography alone during ETT or disjunctively with ST depression has been shown to be a simple and convenient method for the detection of CAD, which was superior to ST depression on the standardized ECG.
Authors: Michel Zuber; Christine H Attenhofer Jost; Peter Kipfer; Sean P Collins; Frank Michota; W Frank Peacock Journal: Ann Noninvasive Electrocardiol Date: 2007-10 Impact factor: 1.468
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Authors: Ian S Harris; Eunyoung Lee; Yerem Yeghiazarians; Barbara J Drew; Andrew D Michaels Journal: J Electrocardiol Date: 2006-03-09 Impact factor: 1.438
Authors: Gregory M Marcus; Ivor L Gerber; Barry H McKeown; Joshua C Vessey; Mark V Jordan; Michele Huddleston; Charles E McCulloch; Elyse Foster; Kanu Chatterjee; Andrew D Michaels Journal: JAMA Date: 2005-05-11 Impact factor: 56.272
Authors: Paul Erne; Therese J Resink; Andrea Mueller; Michael Coslovsky; Richard Kobza; David Conen; Peter Bauer; Patricia Arand Journal: J Atr Fibrillation Date: 2017-06-30
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Authors: Marco Luciani; Matteo Saccocci; Shingo Kuwata; Nikola Cesarovic; Miriam Lipiski; Patricia Arand; Peter Bauer; Andrea Guidotti; Evelyn Regar; Paul Erne; Michel Zuber; Francesco Maisano Journal: Front Physiol Date: 2019-08-22 Impact factor: 4.566