Abstract P308: Detection of Transient Regional Myocardial Ischemia with 80-Electrode Body Surface Delta Map and Its Comparison with Myocardial Perfusion Imaging and 12-Lead ECG
Background The diagnosis of transient regional myocardial ischaemia (TRMI) in patients presenting to the Chest Pain Clinics is a challenge. Traditionally EET has been most commonly employed test for diagnosing TRMI, however due to the limitations of 12-Lead ECG this is no longer recommended. Thus the clinicians have to rely on more expensive and time consuming test including Myocardial Perfusion Imaging (MPI) and Cardiac MRI. Delta Map was described by this group and is an intuitive colour display of digitally subtracted ST segment shift derived from two 80-electrode BSM recordings, one at baseline and one at peak stress.
Objectives The purpose of this pilot study was to asses the diagnostic ability of Delta-Map & 12-Lead ECG in detection of TRMI, and to compare the results with MPI.
Method Forty consecutive patients who were referred by two consultant cardiologist for MPI with a history of angina-like symptoms were consented and recruited in to this study. The Delta Map was derived from two 80-electrode PRIME BSM carried out simultaneously with MPI at rest and peak stress, using dobutamine.12-Lead ECGs were also recorded at the same time.
Results The mean age was 68±7.1, 50% (20/20) were female, 70% (28/40) hyperlipidaemic, 64% (25/40) had history of hypertension and 60% (24/40) were smoker, 27% (11/40) patients had previous PCI. Using MPI as the reference, PRIME Delta Map was more sensitive for the detection of TRMI than the 12-Lead ECG 77% vs. 15%, p 0.0001 and was also more specific for TRMI 96% vs. 84%, p 0.0001. The PPV & NPV for Delta Map was 91% & 89% respectively, where as 33.3% & 66.7% for 12-Lead ECG.
Conclusion The PRIME ECG Delta map is a near patient, rapid, accurate, objective and intuitive method for detecting TRMI and is superior to the 12-Lead ECG. The Delta Map could potentially facilitate more rapid identification and appropriate treatment in patients with coronary artery disease. A larger clinical study is now required.
- © 2011 by American Heart Association, Inc.