Korzeniowska-Kubacka Iwona, Bilińska Maria, Piotrowicz Ryszard
Department of Cardiac Rehabilitation and Noninvasive Electrocardiology, National Institute of Cardiology, Warsaw, Poland.
Ann Noninvasive Electrocardiol. 2005 Jul;10(3):281-7. doi: 10.1111/j.1542-474X.2005.00547.x.
Seismocardiography (SCG) is a useful method for the detection of exercise-induced changes in cardiac muscle contractility which may occur during myocardial ischemia. The aim of this study was to compare the diagnostic accuracy of SCG with electrocardiographic exercise test (ETT) for diagnosis of ischemia in patients with angiographically proved coronary artery disease (CAD).
Seventy-seven male patients with CAD without myocardial infarction (MI), mean age 51+/-9 years, were subjected to SCG and ETT. A gender-matched control group consisted of 30 healthy volunteers aged 34+/-7 years. SCG was done simultaneously with resting supine 12-lead electrocardiography before and immediately after a symptom-limited ETT. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of SCG were compared with ETT. Moreover, the diagnostic accuracy of both the methods was compared, with coronary angiography being the reference for the analysis.
SCG was more sensitive (61.1% vs 44.2%, P<0.05) and accurate (70% vs 61%, P<0.05) method for detecting ischemia caused by coronary stenosis>or=50%, at least in one coronary artery compared to the ETT. However, ETT had better specificity than SCG (82.4% vs 76%, P<0.05). The PPV and NPV of SCG were significantly better than those obtained with ETT (77.9% vs 76%, P<0.05 and 63.4% vs 53.8%, P<0.05, respectively). Moreover, the concordant results of SCG and ETT improved the diagnostic accuracy of both methods.
SCG appeared to be more sensitive for detecting ischemia caused by more than>or=50% stenosis of the main coronary artery compared to an electrocardiographic stress test. SCG was a useful ETT adjunct for selecting patients requiring coronary angiography.
地震心图描记术（SCG）是检测心肌收缩力运动诱发变化的一种有用方法，这种变化可能在心肌缺血期间出现。本研究的目的是比较SCG与心电图运动试验（ETT）对经血管造影证实患有冠状动脉疾病（CAD）患者缺血诊断的准确性。
77例无心肌梗死（MI）的男性CAD患者，平均年龄51±9岁，接受了SCG和ETT检查。一个性别匹配的对照组由30名年龄34±7岁的健康志愿者组成。在症状限制的ETT之前和之后立即，SCG与静息仰卧位12导联心电图同时进行。将SCG的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）与ETT进行比较。此外，以冠状动脉造影为分析参考，比较了两种方法的诊断准确性。
与ETT相比，SCG是检测至少一条冠状动脉中冠状动脉狭窄≥50%引起的缺血更敏感（61.1%对44.2%，P<0.05）和准确（70%对61%，P<0.05）的方法。然而，ETT的特异性比SCG更好（82.4%对76%，P<0.05）。SCG的PPV和NPV显著优于ETT（分别为77.9%对76%，P<0.05和63.4%对53.8%，P<0.05）。此外，SCG和ETT的一致结果提高了两种方法的诊断准确性。
与心电图负荷试验相比，SCG似乎对检测主要冠状动脉≥50%狭窄引起的缺血更敏感。SCG是用于选择需要冠状动脉造影患者的有用的ETT辅助手段。
