Agreement of ECG and Echocardiogram at Stress Echocardiography (1)

  • Research type

    Research Study

  • Full title

    A Single-Centre Retrospective Study: The Level of Agreement between the Stress Electrocardiogram and Stress Echocardiogram in the Transthoracic Stress Echocardiography Setting for Suspected Coronary Artery Disease

  • IRAS ID

    186286

  • Contact name

    Jane Allen

  • Contact email

    jane.allen@york.nhs.uk

  • Duration of Study in the UK

    0 years, 7 months, 7 days

  • Research summary

    Guidelines for suspected coronary artery disease (CAD) were updated in 2010 removing stress electrocardiography, also known as exercise tolerance testing (ETT), for diagnosis or exclusion of the disease. ETT is a non invasive investigation performed on the treadmill with ECG monitoring at rest and stress. Guidelines now recommend functional imaging in its place. The functional imaging modality used at York Teaching Hospital is stress echocardiography (SE) which incorporates echocardiography, ultrasound imaging of the heart, in addition to the previously used ETT at rest and stress. Stress can be induced by exercise or drugs. Exercise stress echocardiography patients only will be included in this study. The same exercise protocol, Bruce is used as in ETT.

    SE is a more expensive and less available investigation than ETT at York Teaching Hospital. Guideline changes have therefore resulted in extended waiting times for SE.

    The purpose of this study is to compare the simultaneous ETT and exercise SE results in terms of positive or negative for CAD in one single NHS centre; York Teaching Hospital. The level of agreement between the ETT and exercise SE result will therefore be assessed to determine the requirement for the echocardiogram in addition to the ETT. This will indicate whether or not the additional echocardiogram is always clinically necessary. Literature suggests the requirement can be influenced by disease prevalence in the population, severity and likelihood of disease so the patients pre test risk score for CAD will be calculated.

    Where possible, results will be compared to the gold standard test for CAD; coronary angiography. As a retrospective study, no patient participation is necessary.

  • REC name

    North East - York Research Ethics Committee

  • REC reference

    15/NE/0345

  • Date of REC Opinion

    13 Oct 2015

  • REC opinion

    Favourable Opinion