DIAGNOSTIC-VALUE OF SIGNAL-AVERAGED CARDIOKYMOGRAPHY FOR THE DETECTION OF ISCHEMIC WALL-MOTION ABNORMALITIES

Cardiokymography (CKG) is a noninvasive method for the registration of left ventricular wall motion. Ischemic left ventricular wall-motion a bnormalities (WMAs) can be detected by typical changes of CKG curves, The purpose of our study was to evaluate the sensitivity and specifici ty of a recently developed signal-averaged CKG system for the detectio n of stress-induced ischemic WMA, We investigated 74 patients who unde rwent dobutamine stress echocardiography (DSE) for suspected or proven coronary artery disease), Precordial CKG curves were recorded at rest and at peak stress with dobutamine, A positive CKG test (indicating i schemic WMA) was defined by typical changes of the CKG curves at peak stress compared to baseline recordings, The CKG test was positive in 2 8 of 38 patients with dobutamine-induced echocardiographic WMA (sensit ivity 74%) and without pathologic changes of the baseline CKG curves i n 29 of 32 patients with a normal DSE test (specificity 91%), The pres ence or absence of echocardiographic WMA at baseline did not influence the sensitivity or specificity of the CKG test, There was no signific ant difference in detecting patients with anterior or posterior WMA by CKG, The results of our study demonstrate that signal-averaged CKG ca n be used to detect patients with ischemic left ventricular dysfunctio n. The sensitivity of CKG test is not influenced by the presence of ba seline WMA at rest and does not depend on the location of left ventric ular ischemia.