Michaelides Andreas P, Fourlas Christos A, Chatzistamatiou Evangelos I, Andrikopoulos George K, Soulis Dimitrios, Psomadaki Zoi D, Stefanadis Christodoulos I
Department of Cardiology, Medical School of Athens University, Hippokration Hospital, Athens, Greece.
Coron Artery Dis. 2007 Jun;18(4):313-8. doi: 10.1097/MCA.0b013e3281689a69.
The accuracy of treadmill exercise testing to detect coronary artery disease is limited in women. This study was undertaken to evaluate whether QRS score can improve the accuracy of treadmill exercise testing in women.
The study population consisted of 114 women with angina-like symptoms, who underwent both treadmill exercise testing and coronary angiography. The impact of QRS score on the standard ST-segment based diagnostic ability of treadmill exercise testing to detect coronary artery disease was studied.
Incorporation of QRS score in standard ST-segment diagnostic criteria significantly enhanced sensitivity (from 59 to 80%), specificity (from 40 to 94%) and diagnostic accuracy (from 50 to 87%) of treadmill exercise testing. The QRS score was shown to reduce significantly the false-positive results from 60 to 6%. Furthermore, QRS score accuracy was correlated with the extent of coronary artery disease. The diagnostic ability of QRS score was greater both among patients with normal and impaired systolic function of the left ventricle.
QRS score can improve the limited diagnostic accuracy of treadmill exercise testing in women, by predominantly decreasing the high prevalence of false-positive results.
在女性中,跑步机运动试验检测冠状动脉疾病的准确性有限。本研究旨在评估QRS评分是否能提高女性跑步机运动试验的准确性。
研究人群包括114名有类心绞痛症状的女性,她们均接受了跑步机运动试验和冠状动脉造影。研究了QRS评分对基于标准ST段的跑步机运动试验检测冠状动脉疾病诊断能力的影响。
将QRS评分纳入标准ST段诊断标准显著提高了跑步机运动试验的敏感性(从59%提高到80%)、特异性(从40%提高到94%)和诊断准确性(从50%提高到87%)。QRS评分显示可将假阳性结果从60%显著降低至6%。此外,QRS评分准确性与冠状动脉疾病程度相关。在左心室收缩功能正常和受损的患者中,QRS评分的诊断能力均更强。
QRS评分可通过主要降低高比例的假阳性结果,提高女性跑步机运动试验有限的诊断准确性。