Utility of the 12-lead electrocardiogram in identifying underlying coronary artery disease in patients with depressed left ventricular systolic function

Mark J. Pirwitz, Richard A. Lange, Charles Landau, Benjamin M. MeShack, L. David Hillis, John E. Willard

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

We assessed the utility of the 12-lead electrocardiogram (ECG) in identifying severe coronary artery disease (CAD) in patients with depressed left ventricular (LV) systolic function. In 336 patients referred for cardiac catheterization with LV ejection fractions <0.50, we compared the 12-lead ECG of those with and without CAD by multivariate analysis. The sensitivities, specificities, and positive and negative predictive values of all dichotomous electrocardiographic variables for identifying the presence of severe CAD were determined. In comparison to subjects with CAD, those without disease were more likely to exhibit left-axis deviation (p=0.01), left bundle branch block (p <0.001), or LV hypertrophy (p <0.001), and less likely to exhibit pathologic inferior Q waves (p <0.001). The presence of anterior or any Q waves was similar between the groups. The presence of any diagnostic Q wave had a positive predictive value of 92%, sensitivity of 57%, and specificity of 80% for identifying severe CAD. In patients with LV systolic dysfunction, lite 12-lead ECG is insensitive and nonspecific for identifying those with concomitant severe CAD.

Original languageEnglish (US)
Pages (from-to)1289-1292
Number of pages4
JournalAmerican Journal of Cardiology
Volume77
Issue number15
DOIs
StatePublished - Jun 15 1996

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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