Detrano R
Saint John's Cardiovascular Research Center, Harbor-UCLA Medical Center, Torrance 90502.
J Electrocardiol. 1992;24 Suppl:54-61. doi: 10.1016/s0022-0736(10)80017-2.
In order to evaluate the variability in the diagnostic accuracy of the exercise electrocardiogram, a meta-analytic database derived from a review of 147 publications and a multicenter database derived from 2,826 angiographic referrals were analyzed. Wide variability in sensitivity and specificity were found from the meta-analytic review (standard deviations of 16% and 15%, respectively). No improvement in reported sensitivities and specificities has been seen over the past 22 years. The sensitivities and specifities derived from the multicenter database also showed wide variability (standard deviation 13% and 5%). These results suggest that despite obvious technologic strides in acquiring, processing, and interpreting exercise ECG signals, the accuracy of the exercise induced ST depression has not increased greatly and is difficult to ascertain a priori in a given laboratory. Individual anatomic and physiologic differences are postulated as limiting factors in the accuracy that can be obtained from this noninvasive test.
为了评估运动心电图诊断准确性的变异性，对一个来自147篇出版物综述的荟萃分析数据库以及一个来自2826例血管造影转诊病例的多中心数据库进行了分析。荟萃分析综述发现敏感性和特异性存在很大变异性（标准差分别为16%和15%）。在过去22年中，报告的敏感性和特异性未见改善。多中心数据库得出的敏感性和特异性也显示出很大变异性（标准差为13%和5%）。这些结果表明，尽管在获取、处理和解释运动心电图信号方面技术有了明显进步，但运动诱发ST段压低的准确性并未大幅提高，且在特定实验室很难事先确定。个体解剖和生理差异被认为是这种无创检查准确性的限制因素。
