Jelinek V M, Herman M V, Schweitzer P, Gorlin R
Aust N Z J Med. 1976 Feb;6(1):22-5. doi: 10.1111/j.1445-5994.1976.tb03286.x.
This study has assessed whether chest pain occurring during or after a step test could improve the accuracy of exercise testing in the diagnosis of coronary artery disease (CAD). One hundred and fifty-three consecutive men underwent the double Master two-step test prior to diagnostic coronary arteriography. On hundred and twenty-five had CAD, 28 insignificant disease (NCA). The post-exercise ECG showed at least 0-5 mm of ischaemic ST depression in 71 (57%) of the men with CAD and in five (18%) with NCA. Ischaemic ST depression of at least 2-0 mm occurred in 24 men, all of whom had CAD. Chest pain occurred during or after the test in 78 (62%) men with CAD and in nine (33%) with NCA. The accuracy of diagnosis of CAD could be improved by combining the occurrence of chest pain in the test with a positive post-exercise ECG. Either a 2 mm positive post-exercise ECG with or without test angina or 0-5 mm to 1-9 mm positive post-exercise ECG with test angina was found in 56 (45%) of men with CAD and one (4%) with NCA. Thus the concurrence of chest pain during or after a double Master two-step test, together with ischaemic ST segment depression after the test, strongly suggests the presence of CAD.
本研究评估了在阶梯试验期间或之后出现的胸痛是否能提高运动试验对冠状动脉疾病（CAD）诊断的准确性。153名连续的男性在进行诊断性冠状动脉造影之前接受了双倍马斯特二级阶梯试验。其中125人患有CAD，28人有非显著性疾病（NCA）。运动后心电图显示，71名（57%）CAD男性和5名（18%）NCA男性出现至少0 - 5毫米的缺血性ST段压低。24名男性出现至少2.0毫米的缺血性ST段压低，他们均患有CAD。78名（62%）CAD男性和9名（33%）NCA男性在试验期间或之后出现胸痛。将试验中胸痛的出现与运动后心电图阳性相结合可提高CAD的诊断准确性。在56名（45%）CAD男性和1名（4%）NCA男性中发现，运动后心电图阳性2毫米（无论有无试验性心绞痛）或运动后心电图阳性0.5毫米至1.9毫米且伴有试验性心绞痛。因此，双倍马斯特二级阶梯试验期间或之后胸痛的同时出现，以及试验后缺血性ST段压低，强烈提示CAD的存在。
