Yap Lok B, Arshad Waleed, Jain Ajay, Kurbaan Arvinder S, Garvie Neil W
Division of Cardiology, Homerton Hospital, Homerton Row, London E9 6SR, UK.
Int J Cardiovasc Imaging. 2005 Apr-Jun;21(2-3):253-8; discussion 259-60. doi: 10.1007/s10554-004-2458-y.
ST segment depression on the electrocardiogram during the exercise treadmill test (ETT) is used as a predictor of coronary artery disease (CAD), although it is recognised that both false-positive and false-negative results limit the value of this procedure. Although adenosine does not produce an inotropic or chronotropic effect upon the myocardium it may cause ST depression during infusion.
The 12-lead ECG recordings obtained during 825 adenosine stress and 425 ETT procedures, performed as part of a 2-day Tc-MIBI protocol, were retained for examination and comparison with the appearances at subsequent myocardial perfusion imaging (MPI).
ST depression was associated with 44 (4.9%) of the adenosine stress and 44 (10.4%) of the ETT procedures. Both 1 and 2 mm ST depression during adenosine stress were significant predictors of reversible ischaemia (p < 0.01; p < 0.01). However, even though 2 mm ST depression on ETT was significant as a predictor of reversible ischaemia (p < 0.01), 1 mm ST depression on ETT was not (p = 0.4). There were more female cases with false positive ECG changes in both the adenosine stress (63.6%) group and the ETT (66.7%) group. There was no significant correlation between the territory of the ischaemic changes seen on the ECG with the location of defects developing on MPI in both the adenosine stress and ETT groups.
ST depression of 1 mm occurring with adenosine stress, unlike with the ETT, is a significant predictor of ischaemia.
运动平板试验（ETT）期间心电图上的ST段压低被用作冠状动脉疾病（CAD）的预测指标，尽管人们认识到假阳性和假阴性结果都会限制该检查的价值。虽然腺苷对心肌没有变力或变时作用，但在输注过程中可能会导致ST段压低。
在一项为期2天的锝-甲氧基异丁基异腈（Tc-MIBI）检查方案中，对825例腺苷负荷试验和425例ETT检查过程中获得的12导联心电图记录进行留存，以便与随后的心肌灌注显像（MPI）表现进行检查和比较。
ST段压低与44例（4.9%）腺苷负荷试验及44例（10.4%）ETT检查相关。腺苷负荷试验期间1毫米和2毫米的ST段压低均是可逆性缺血的显著预测指标（p<0.01；p<0.01）。然而，尽管ETT上2毫米的ST段压低作为可逆性缺血的预测指标具有显著性（p<0.01），但ETT上1毫米的ST段压低并非如此（p=0.4）。腺苷负荷试验组（63.6%）和ETT组（66.7%）中，女性出现心电图假阳性改变的病例更多。在腺苷负荷试验组和ETT组中，心电图上所见缺血改变的区域与MPI上出现缺损的位置之间均无显著相关性。
与ETT不同，腺苷负荷试验时出现的1毫米ST段压低是缺血的显著预测指标。
