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Asian Cardiovasc Thorac Ann 2008;16:103-106
© 2008 Asia Publishing EXchange Ltd

ORIGINAL CONTRIBUTIONS

Differentiation of Ischemic and Dilated Cardiomyopathy on Electrocardiograms

Kamran Aghasadeghi, MD, Amir Aslani, MD

Department of Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran

For reprint information contact: Amir Aslani, MD, Tel: 98 711 843 3095, Fax: 98 711 227 7182, Email: aslanidr{at}yahoo.com, Namazee Hospital, PO Box 71935 1334, Shiraz, Iran.

Differentiating coronary artery disease with left ventricular dysfunction from dilated cardiomyopathy is important prognostically and therapeutically. To provide a diagnostic algorithm to distinguish these conditions using a standard 12-lead electrocardiogram, all 105 patients with left ventricular ejection fraction < 50% who underwent angiography between January 2004 and December 2006 were studied prospectively. Coronary artery disease was defined as ≥ 50% stenosis of the left main coronary artery or ≥ 70% stenosis of 1 or more of the 3 major epicardial arteries. Normal coronary angiography findings with left ventricular ejection fraction < 50% was defined as dilated cardiomyopathy. The most specific finding for differentiation of these diseases was pathologic Q waves in lead II, aVF, V3 or V4. The most sensitive parameter was a ratio ≥ 5 of R-wave amplitudes in lead V6 and lead III (94% sensitive). The 12-lead electrocardiogram provides a useful noninvasive method for differentiation of dilated cardiomyopathy from coronary artery disease with left ventricular systolic dysfunction.






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