Schreck D M, Terndrup T E, Bosco S F, Zacharias D, Ng L, Schreck B S
Morristown Memorial Hospital, NJ.
Crit Care Med. 1989 Mar;17(3):269-73. doi: 10.1097/00003246-198903000-00014.
Signal processing was applied to normal ECGs to study whether the results could predict coronary artery disease (CAD) on angiography. ECGs determined to be normal by conventional criteria for 116 white males and 84 white females were subjected to signal processing. The technique applied nonlinear mathematical transformation to a segment of seven ECG leads which were photographically imaged, automatically digitized, normalized for time, and had topographical coordinate transformation using an IBM-XT microcomputer. The resulting curvilinear display on the computer monitor was termed a biopotential coordinate transformation (BCT). Successive superimposition of BCTs from normal ECGs of patients with normal angiograms developed boundaries of a normal template for each lead. Study BCTs were then compared to the normal templates to predict the presence or absence of CAD. Correlation of the BCT results with the severity of CAD for the males resulted in average sensitivities of 80%, 84.4%, and 91.7% for single, double, and triple-vessel CAD, respectively. Similarly, for the females average sensitivities were 59.1%, 73.9%, and 88.9%, respectively. In past studies on the same population, the BCT process detected CAD with average sensitivity of 85.1% and specificity of 81.8% for white males and average sensitivity of 73% and specificity 81% for white females. As such, computerized signal processing of ECGs may provide a noninvasive method for detection of CAD in patients with seemingly normal resting ECGs. The results of this study indicate that the sensitivity of the process increases in direct proportion to the severity of CAD. Further investigation is warranted for process refinement and verification.
对正常心电图进行信号处理，以研究其结果能否预测血管造影显示的冠状动脉疾病（CAD）。对116名白人男性和84名白人女性的心电图进行常规标准判定为正常后，进行信号处理。该技术对一段七条心电图导联进行非线性数学变换，这些导联经过摄影成像、自动数字化、时间归一化，并使用IBM-XT微型计算机进行地形坐标变换。计算机显示器上生成的曲线显示被称为生物电位坐标变换（BCT）。对血管造影正常患者的正常心电图的BCT进行连续叠加，为每个导联建立正常模板边界。然后将研究用BCT与正常模板进行比较，以预测CAD的存在与否。男性BCT结果与CAD严重程度的相关性显示，单支、双支和三支血管CAD的平均敏感性分别为80%、84.4%和91.7%。同样，女性的平均敏感性分别为59.1%、73.9%和88.9%。在过去对同一人群的研究中，BCT过程检测CAD的平均敏感性，白人男性为85.1%，特异性为81.8%；白人女性平均敏感性为73%，特异性为81%。因此，对心电图进行计算机化信号处理可能为检测静息心电图看似正常的患者的CAD提供一种非侵入性方法。本研究结果表明，该过程的敏感性与CAD的严重程度成正比增加。有必要进一步研究以完善和验证该过程。
