Ischemia detection in women: The diagnostic value of exercise QRS duration changes

Aim: To compare the diagnostic accuracy of exercise electrocardiographic (ECG) ST-T changes and QRS duration changes as a means of ischemia detection in a female population. Methods and Results: A total of 101 women from a pool of 318 referred for ECG stress testing underwent standard testing using ST-T criteria with the additional measurement of QRS duration before and at peak exercise using a new computerized optic scanner for precise QRS duration measurement. The diagnostic accuracy of the test was determined using planar thallium stress testing as a 'gold standard.' For the overall population, the sensitivity of ST-T criteria was 47% with a specificity of 58%. The sensitivity of QRS duration changes was 91% with a specificity of 89%. For Group 1 (age 27-50) the sensitivity of the ST-T criteria was 40% with a specificity of 58%. The sensitivity of the QRS duration changes was 80% with a specificity of 83%. For Group 2 (age 51-83), the sensitivity of the ST-T criteria was 43% with a specificity of 56%. The sensitivity of the QRS duration changes was 94% with a specificity of 90%. Conclusion: In our female population exercise, QRS duration changes using our computerized method were better markers of ischemia than standard ST-T criteria.