Cardiodynamicsgram as a New Diagnostic Tool in Coronary Artery Disease Patients With Nondiagnostic Electrocardiograms

Abstract

Cardiodynamicsgram (CDG) has emerged recently as a noninvasive spatiotemporal electrocardiographic method for subtle cardiac dynamics information analysis within electrocardiogram (ECG). This study sought to evaluate the clinical utility of CDG for early coronary artery disease (CAD) detection in suspected patients with CAD presenting with nondiagnostic ECGs. A total of 421 suspected patients with CAD presenting with nondiagnostic ECG were enrolled. Standard 12-lead ECG and CDG were performed simultaneously, 1 day before invasive coronary angiography. Diagnostic accuracy of CDG for early CAD detection was assessed with reference to coronary angiography as the gold standard. Coronary angiography showed ≥1 coronary arteries stenosis of >50% in 347 patients. Of these 347 patients with CAD, 294 patients were positive in CDG. Of 74 non-CAD controls, 63 patients were negative in CDG. Diagnostic accuracy of CDG at presentation for CAD was 84.6%, sensitivity 84.7%, and specificity 83.7%. In patients presenting with nondiagnostic ECGs, an abnormal status can be detected early through noninvasive CDG. CDG is highly sensitive for the early diagnosis of CAD. Underlying causes of false-negative CDG findings included number of diseased coronary arteries and collateral circulation. Subtle myocardial damage that was not detectable on coronary angiography might be the major cause of false-positive findings.