Marzoog Basheer Abdullah, Chomakhidze Peter, Gognieva Daria, Silantyev Artemiy, Suvorov Alexander, Abdullaev Magomed, Mozzhukhina Natalia, Filippova Darya Alexandrovna, Kostin Sergey Vladimirovich, Kolpashnikova Maria, Ershova Natalya, Ushakov Nikolay, Mesitskaya Dinara, Kopylov Philipp
World-Class Research Center Digital Biodesign and Personalized Healthcare, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya Street, 119991, Moscow, Russia.
University Clinical Hospital Number 1, Cardiology Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8-2 Trubetskaya Street, 119991, Moscow, Russia.
World J Cardiol. 2025 Apr 26;17(4):104396. doi: 10.4330/wjc.v17.i4.104396.
Ischemic heart disease (IHD) impacts the quality of life and has the highest mortality rate of cardiovascular diseases globally.
To compare variations in the parameters of the single-lead electrocardiogram (ECG) during resting conditions and physical exertion in individuals diagnosed with IHD and those without the condition using vasodilator-induced stress computed tomography (CT) myocardial perfusion imaging as the diagnostic reference standard.
This single center observational study included 80 participants. The participants were aged ≥ 40 years and given an informed written consent to participate in the study. Both groups, G1 ( = 31) with and G2 ( = 49) without post stress induced myocardial perfusion defect, passed cardiologist consultation, anthropometric measurements, blood pressure and pulse rate measurement, echocardiography, cardio-ankle vascular index, bicycle ergometry, recording 3-min single-lead ECG (Cardio-Qvark) before and just after bicycle ergometry followed by performing CT myocardial perfusion. The LASSO regression with nested cross-validation was used to find the association between Cardio-Qvark parameters and the existence of the perfusion defect. Statistical processing was performed with the R programming language v4.2, Python v.3.10 [^R], and Statistica 12 program.
Bicycle ergometry yielded an area under the receiver operating characteristic curve of 50.7% [95% confidence interval (CI): 0.388-0.625], specificity of 53.1% (95%CI: 0.392-0.673), and sensitivity of 48.4% (95%CI: 0.306-0.657). In contrast, the Cardio-Qvark test performed notably better with an area under the receiver operating characteristic curve of 67% (95%CI: 0.530-0.801), specificity of 75.5% (95%CI: 0.628-0.88), and sensitivity of 51.6% (95%CI: 0.333-0.695).
The single-lead ECG has a relatively higher diagnostic accuracy compared with bicycle ergometry by using machine learning models, but the difference was not statistically significant. However, further investigations are required to uncover the hidden capabilities of single-lead ECG in IHD diagnosis.
缺血性心脏病（IHD）影响生活质量，在全球心血管疾病中死亡率最高。
以血管扩张剂诱导的应激计算机断层扫描（CT）心肌灌注成像作为诊断参考标准，比较确诊为IHD的个体与未患该病的个体在静息状态和体力活动期间单导联心电图（ECG）参数的变化。
这项单中心观察性研究纳入了80名参与者。参与者年龄≥40岁，并签署了知情同意书以参与研究。两组，G1组（n = 31）有应激后心肌灌注缺损，G2组（n = 49）无应激后心肌灌注缺损，均通过心脏病专家会诊、人体测量、血压和脉搏率测量、超声心动图、心踝血管指数、自行车测力计测试，在自行车测力计测试前和测试后立即记录3分钟单导联心电图（Cardio-Qvark），随后进行CT心肌灌注检查。使用带有嵌套交叉验证的LASSO回归来发现Cardio-Qvark参数与灌注缺损存在之间的关联。使用R编程语言v4.2、Python v.3.10 [^R]和Statistica 12程序进行统计处理。
自行车测力计测试的受试者工作特征曲线下面积为50.7% [95%置信区间（CI）：(0.388 - 0.625)]，特异性为53.1%（95%CI：(0.392 - 0.673)），敏感性为48.4%（95%CI：(0.306 - 0.657)）。相比之下，Cardio-Qvark测试表现明显更好，受试者工作特征曲线下面积为67%（95%CI：(0.530 - 0.801)），特异性为75.5%（95%CI：(0.628 - 0.88)），敏感性为51.6%（95%CI：(0.333 - 0.695)）。
通过机器学习模型，单导联心电图与自行车测力计测试相比具有相对较高的诊断准确性，但差异无统计学意义。然而，需要进一步研究以揭示单导联心电图在IHD诊断中的潜在能力。
