Oliver I. Brown
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
Andrew L. Clark
Benjamin J. Davison
Adam N. Mather
Michael S. Cunnington
Dr Angela Hoye Angela.Hoye@hull.ac.uk
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. https://doi.org/10.1007/s13239-018-0354-1
|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|
|Peer Reviewed||Peer Reviewed|
|Keywords||Cardiogoniometry; Fractional flow reserve; Coronary artery disease; Vectorcardiography; Diagnostic accuracy|
© The Author(s) 2018<br /> Open Access<br /> This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), 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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