Intracoronary ECG ST-segment shift remission time during reactive myocardial hyperemia. A new method to assess hemodynamic coronary stenosis severity
Loading...
Author (Corporation)
Publication date
01.10.2024
Typ of student thesis
Course of study
Type
01A - Journal article
Editors
Editor (Corporation)
Supervisor
Parent work
American Journal of Physiology. Heart and Circulatory Physiology
Special issue
DOI of the original publication
Link
Series
Series number
Volume
327
Issue / Number
4
Pages / Duration
1124-1131
Patent number
Publisher / Publishing institution
American Physiological Society
Place of publication / Event location
Edition
Version
Programming language
Assignee
Practice partner / Client
Abstract
Fractional flow reserve (FFR) measurements are recommended for assessing hemodynamic coronary stenosis severity. Intracoronary ECG (icECG) is easily obtainable and highly sensitive in detecting myocardial ischemia due to its close vicinity to the myocardium. We hypothesized that the remission time of myocardial ischemia on icECG after a controlled coronary occlusion accurately detects hemodynamically relevant coronary stenosis. This retrospective, observational study included patients with chronic coronary syndrome undergoing hemodynamic coronary stenosis assessment immediately following a strictly 1-min proximal coronary artery balloon occlusion with simultaneous icECG recording. icECG was used for a beat-to-beat analysis of the ST-segment shift during reactive hyperemia immediately following balloon deflation. The time from coronary balloon deflation until the ST-segment shift reached 37% of its maximum level, i.e., icECG ST-segment shift remission time (τ-icECG in seconds), was obtained by an automatic algorithm. τ-icECG was tested against the simultaneously obtained reactive hyperemia FFR at a threshold of 0.80 as a reference parameter. From 120 patients, 139 icECGs (age, 68 ± 10 yr old) were analyzed. Receiver operating characteristic (ROC) analysis of τ-icECG for the detection of hemodynamically relevant coronary stenosis at an FFR of ≤0.80 was performed. The area under the ROC curve was equal to 0.621 (P = 0.0363) at an optimal τ-icECG threshold of 8 s (sensitivity, 61%; specificity, 67%). τ-icECG correlated inversely and linearly with FFR (P = 0.0327). This first proof-of-concept study demonstrates that τ-icECG, a measure of icECG ST segment-shift remission after a 1-min coronary artery balloon occlusion accurately detects hemodynamically relevant coronary artery stenosis according to FFR at a threshold of ≥8 s.
Keywords
Subject (DDC)
Event
Exhibition start date
Exhibition end date
Conference start date
Conference end date
Date of the last check
ISBN
ISSN
0363-6135
1522-1539
1522-1539
Language
English
Created during FHNW affiliation
Yes
Strategic action fields FHNW
Publication status
Published
Review
Peer review of the complete publication
Open access category
Hybrid
License
Citation
Bigler, M. R., Kieninger-Gräfitsch, A., Rohla, M., Corpateaux, N., Waldmann, F., Wildhaber, R., Häner, J., & Seiler, C. (2024). Intracoronary ECG ST-segment shift remission time during reactive myocardial hyperemia. A new method to assess hemodynamic coronary stenosis severity. American Journal of Physiology. Heart and Circulatory Physiology, 327(4), 1124–1131. https://doi.org/10.1152/ajpheart.00481.2024