Author + information
- Received October 20, 1986
- Revision received April 22, 1987
- Accepted May 8, 1987
- Published online October 1, 1987.
- ↵*Address for reprints: Robert Detrano, MD, Chief, Heart Station, Long Beach VA Medical Center, 5901 East 7th Street, Long Beach, California 90822.
Computer-assisted interpretation of the exercise electrocardiogram has been advocated to improve the accuracy of diagnosing coronary artery disease. Its accuracy was compared with a blinded visual interpretation of exercise-induced ST depression in 271 consecutive subjects without prior myocardial infarction who were referred for coronary angiography. The sensitivity of the visual and computer readings was 0.51 and 0.51, respectively, at a specificity of 0.87. Receiver operating characteristic curves were generated for the visual and computer ST depression in lead V5. Analysis of the areas under these curves showed no significant difference between them, indicating that computer-assisted analysis was not superior to unmodified visual analysis. A similar analysis was applied to two other computer indexes reported to be superior to visual assessments (treadmill exercise score and ST index). These computer indexes were not superior to a conventional visual analysis of leads I, II, V2, V4and V5in predicting severe disease (>50% luminal narrowing).
These results suggest that computer-assisted interpretation does not improve the accuracy of exercise electrocardiography in diagnosing coronary artery disease in subjects without prior myocardial infarction.
- Received October 20, 1986.
- Revision received April 22, 1987.
- Accepted May 8, 1987.
- American College of Cardiology Foundation