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Cardiogoniometry compared to fractional flow reserve at identifying physiologically significant coronary stenosis: The Cardioflow Study

Brown, Oliver I.; Clark, Andrew L.; Chelliah, Raj; Davison, Benjamin J.; Mather, Adam N.; Cunnington, Michael S.; John, Joseph; Alahmar, Albert; Oliver, Richard; Aznaouridis, Konstantinos; Hoye, Angela


Oliver I. Brown

Andrew L. Clark

Raj Chelliah

Benjamin J. Davison

Adam N. Mather

Michael S. Cunnington

Joseph John

Albert Alahmar

Richard Oliver

Konstantinos Aznaouridis


Cardiogoniometry (CGM) is method of 3-dimensional electrocardiographic assessment which has been shown to identify patients with angiographically defined, stable coronary artery disease (CAD). However, angiographic evidence of CAD, does not always correlate to physiologically significant disease. The aim of our study was to assess the ability of CGM to detect physiologically significant coronary stenosis defined by fractional flow reserve (FFR). In a tertiary cardiology centre, elective patients with single vessel CAD were enrolled into a prospective double blinded observational study. A baseline CGM recording was performed at rest. A second CGM recording was performed during the FFR procedure, at the time of adenosine induced maximal hyperaemia. A significant CGM result was defined as an automatically calculated ischaemia score < 0 and a significant FFR ratio was defined as < 0.80. Measures of diagnostic performance (including sensitivity and specificity) were calculated for CGM at rest and during maximal hyperaemia. Forty-five patients were included (aged 61.1 ± 11.0; 60.0% male), of which eighteen (40%) were found to have significant CAD when assessed by FFR. At rest, CGM yielded a sensitivity of 33.3% and specificity of 63.0%. At maximal hyperaemia the sensitivity and specificity of CGM was 71.4 and 50.0% respectively. The diagnostic performance of CGM to detect physiologically significant stable CAD is poor at rest. Although, the diagnostic performance of CGM improves substantially during maximal hyperaemia, it does not reach sufficient levels of accuracy to be used routinely in clinical practice.


Brown, O. I., Clark, A. L., Chelliah, R., Davison, B. J., Mather, A. N., Cunnington, M. S., …Hoye, A. (2018). Cardiogoniometry compared to fractional flow reserve at identifying physiologically significant coronary stenosis: The Cardioflow Study. Cardiovascular Engineering and Technology, 9(3), 439-446.

Journal Article Type Article
Acceptance Date Mar 23, 2018
Online Publication Date Apr 12, 2018
Publication Date Sep 15, 2018
Deposit Date Jul 6, 2018
Publicly Available Date Jul 6, 2018
Print ISSN 1869-408X
Electronic ISSN 1869-4098
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 9
Issue 3
Pages 439-446
Keywords Cardiogoniometry; Fractional flow reserve; Coronary artery disease; Vectorcardiography; Diagnostic accuracy
Public URL
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Article (760 Kb)

Copyright Statement
&copy; The Author(s) 2018<br /> Open Access<br /> This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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