Role of exercise cardiogoniometry in coronary artery disease diagnostics.

Abstract

The use of noninvasive diagnostics in coronary artery disease remains underdeveloped. To date, there is no simple and inexpensive method that can lead to a reliable diagnosis. Aside from costly and elaborate imaging techniques, exercise ECG, with its rather moderate sensitivity and specificity, is the main diagnostic method available. In this prospective study of 109 patients, the diagnostic value of cardiogoniometry (CGM), a three-dimensional, computer-analyzed vector cardiogram, was determined before and after physical stress, and the results were compared with those obtained from a stress test. We also investigated whether the sensitivity and specificity of the classical bicycle stress test could be increased with the addition of measurements obtained by CGM. Coronary angiography was used as a reference method. CGM had a sensitivity of 39% at rest and 42% after physical stress and a specificity of 63% at rest and 57% after stress. This method was found to be markedly inferior to pre-test probability (sensitivity 53%, specificity 81%), stress ECG (sensitivity 52%, specificity 81%), and resting ECG (sensitivity 50%, specificity 64%). The efficiency of exercise ECG testing was not improved by use of CGM results. If CGM is to be established as a viable diagnostic method in daily clinical practice, it must undergo further development.