Hirano Yutaka, Uehara Hisakazu, Nakamura Hajime, Ikuta Shin-ichirou, Nakano Manabu, Akiyama Seita, Ishikawa Kinji
Department of Cardiology, Kinki University School of Medicine, Osaka, Japan.
J Am Soc Echocardiogr. 2006 May;19(5):536-9. doi: 10.1016/j.echo.2006.01.006.
Exercise echocardiography is an effective means of noninvasively detecting coronary artery disease (CAD), and hand-carried cardiac ultrasound (HCU) devices are now being used to diagnose CAD in emergency rooms and at bedsides.
To compare the efficacies of exercise echocardiography with an HCU device (EchoCG-HCU) and exercise electrocardiography (ECG) in the diagnosis of CAD.
Fifty-eight patients underwent symptom-limited treadmill exercise testing. Two-dimensional echocardiographic images were obtained from standard parasternal and apical windows at rest and immediately after exercise using an HCU device (180 PLUS SonoSite Inc, Bothell, Wash). Wall motion was scored for each of 16 left ventricular segments using a 5-point grading system. The development of new or worsening wall motion was considered to be indicative of ischemia.
When identifying CAD using exercise ECG, the sensitivity ws 63%, the specificity was 72%, and the diagnostic accuracy was 69%. By comparison, with exercise EchoCG-HCU the sensitivity was 68%, the specificity was 90%, and the diagnostic accuracy was 83%. Moreover, the specificity of exercise EchoCG-HCU was significantly higher than that of exercise ECG (p < .05).
Exercise EchoCG-HCU is at least as useful as exercise ECG for diagnosing CAD.
运动超声心动图是无创检测冠状动脉疾病（CAD）的有效手段，目前手提式心脏超声（HCU）设备正用于急诊室和床边CAD的诊断。
比较运动超声心动图联合HCU设备（EchoCG-HCU）与运动心电图（ECG）在CAD诊断中的效能。
58例患者接受症状限制性平板运动试验。使用HCU设备（美国华盛顿州博塞尔市索诺赛特公司180 PLUS型）于静息状态及运动结束后即刻从标准胸骨旁和心尖切面获取二维超声心动图图像。采用5分制评分系统对16个左心室节段的室壁运动进行评分。新出现或恶化的室壁运动被视为心肌缺血的表现。
采用运动心电图诊断CAD时，敏感性为63%，特异性为72%，诊断准确性为69%。相比之下，采用运动EchoCG-HCU时，敏感性为68%，特异性为90%，诊断准确性为83%。此外，运动EchoCG-HCU的特异性显著高于运动心电图（p < 0.05）。
运动EchoCG-HCU在诊断CAD方面至少与运动心电图同样有用。
