Population Screening with Respect to Cardiac Ischemia

心脏缺血的人群筛查

• 批准号: 6832968
• 负责人: Joseph M Starobin
• 金额: $ 9.93万
• 依托单位: MEDIWAVE STAR TECHNOLOGY, INC.
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-01 至 2006-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6832968
• 关键词: cardiovascular stress test; coronary disorder; cost effectiveness; diagnosis design /evaluation; early diagnosis; electrocardiographic monitor; exercise; heart disorder diagnosis; heart rate; human data; mass screening; myocardial ischemia /hypoxia; noninvasive diagnosis

DESCRIPTION (provided by applicant): Early detection of cardiac ischemia (CI) is important for diagnosis and treatment of coronary artery disease (CAD). CI is usually first observed as changes in ECG's ST segment during exercise. However, there is an extensive body of literature showing that the ST segment change is relatively insensitive and only a moderately specific CAD predictor. Hence, most clinicians refer patients for more expensive and labor intensive radioisotope imaging. A simpler, inexpensive and reliable technology for detecting CI in an asymptomatic population would open the door to early diagnostics of CAD through mass cardiac screening and better management of CAD patients. Mediwave Star Technology (MSTI) pilot studies revealed that heart rate variability (HRV) follows a hysteresis pattern during a proprietary quasi-stationary there-and-back exercise protocol. We propose to use this phenomenon as a basis for a simple inexpensive test using commercially available digital heart rate monitors. MSTI in collaboration with Cleveland Clinic Foundation has just completed data collection in a blind clinical study involving 260 patients and initially aimed at comparison of our QT-RR hysteresis technology with radioisotope imaging. We propose to reprocess these data to assess specificity and sensitivity of our HRV hysteresis method. This will open up a new avenue for a simple and inexpensive non-invasive tool for early diagnostics of CI in mass screening of asymptomatic population.

描述（申请人提供）：早期发现心脏缺血（CI）对冠状动脉疾病（CAD）的诊断和治疗非常重要。CI通常首先观察到心电图ST段在运动过程中的变化。然而，有大量的文献表明，ST段的变化是相对不敏感的，只是一个中等特异性的CAD预测因子。因此，大多数临床医生建议患者进行更昂贵和劳动密集型的放射性同位素成像。在无症状人群中检测CI的一种更简单、廉价和可靠的技术，将通过大规模心脏筛查和更好地管理CAD患者，为CAD的早期诊断打开大门。Mediwave Star Technology （MSTI）的初步研究表明，在专有的准静态前后运动方案中，心率变异性（HRV）遵循滞后模式。我们建议以这种现象为基础，使用市售的数字心率监测器进行简单廉价的测试。MSTI与克利夫兰诊所基金会合作，刚刚完成了一项涉及260名患者的盲临床研究的数据收集，初步目的是比较我们的QT-RR迟滞技术与放射性同位素成像。我们建议重新处理这些数据，以评估我们的HRV迟滞方法的特异性和敏感性。这将为大规模无症状人群筛查CI的早期诊断开辟一条简单、廉价、无创的新途径。