Overview
To evaluate the ability of exercise ECG to discriminate between hypertensive heart disease-related and CAD-related abnormalities
Description
In this prospective study, consecutive patients undergoing evaluation for suspected coronary artery disease will undergo exercise ECG testing (ExECG), transthoracic echocardiography (TTE), stress cardiac magnetic resonance (CMR), and coronary computed tomography angiography (CCTA).
Patients will be stratified into four groups according to the presence or absence of LVH and obstructive CAD:
LVH with obstructive CAD LVH without obstructive CAD No LVH with obstructive CAD No LVH without obstructive CAD
LVH will be defined by standard echocardiographic criteria, while obstructive CAD will be assessed by CCTA. Stress CMR will serve as the reference standard for inducible myocardial ischemia.
Exercise ECG parameters will include conventional ST-segment criteria as well as dynamic indices during exercise and recovery. Associations between ECG findings and imaging-defined phenotypes will be evaluated, and predictors of CAD-related ischemia will be identified.
Results The study will assess the diagnostic performance of exercise ECG across the four predefined groups. Differences in ECG response patterns will be compared according to the presence of LVH and obstructive CAD. Multivariable analysis will be performed to identify independent ECG predictors associated with obstructive CAD and inducible ischemia.
Eligibility
Inclusion Criteria:
- Patients with CAD and LVH
Exclusion Criteria:
- Patients with RBBB
