Hase H, Nakamura R, Inishi Y, Degawa T, Yabuki S, Machii K, Tsuyuki K
Third Department of Internal Medicine, Toho University Ohashi Hospital.
Kokyu To Junkan. 1991 Nov;39(11):1159-64.
Coronary angiography was performed in 250 patients with a significant ischemic ST segment change detected by symptom-limited maximum treadmill exercise testing, and relationship between anatomical severity of coronary artery disease and parameters in exercise testing was studied. The age of the patients ranged from 34 to 76 years (188 men, 62 women). One-vessel disease (1VD) was presented in 82 patients, two-vessel disease (2VD) in 42, three-vessel disease or left main coronary disease (3VD) in 26, and no significant stenosis was presented in 100 subjects (Normal). Functional aerobic impairement (FAI) was evaluated in each group as a parameter of exercise capacity, myocardial aerobic impairment (MAI) and heart rate impairment (HRI) were also evaluated as a parameter of maximum myocardial oxygen requirements and maximum heart rate, respectively. Using these parameters, discriminant analysis was performed to compare the group with significant coronary artery disease and the Normal group. Also, to compare the group with multi-vessel disease and the group with less than 2VD. Also, the 3VD group and the group with less than 3VD. FAI, MAI and HRI were significantly different (p less than 0.0001) in each group. The discriminant formula to separate the group of significant coronary artery disease from the Normal group was Z = -1.049 + 0.02 [FAI] +0.08 [MAI] +0.03 [HRI]. According to this formula, sensitivity was 92.5% and specificity was 71.5%. The discriminant formula to separate the group with multi-vessel disease from the group with less than 2VD was Z = -4.731 + 0.07 [FAI] +0.106 [MAI] +0.02 [HRI]. According to this formula, sensitivity was 96.3% and specificity was 78.8%.(ABSTRACT TRUNCATED AT 250 WORDS)
对250例通过症状限制最大平板运动试验检测出有显著缺血性ST段改变的患者进行了冠状动脉造影，并研究了冠状动脉疾病的解剖严重程度与运动试验参数之间的关系。患者年龄在34至76岁之间（男性188例，女性62例）。82例患者为单支血管病变（1VD），42例为双支血管病变（2VD），26例为三支血管病变或左主干冠状动脉病变（3VD），100例受试者无明显狭窄（正常）。每组均评估了功能性有氧能力损害（FAI）作为运动能力参数，还分别评估了心肌有氧损害（MAI）和心率损害（HRI）作为最大心肌需氧量和最大心率参数。使用这些参数进行判别分析，以比较有显著冠状动脉疾病的组与正常组。此外，比较多支血管病变组与少于2支血管病变组。还有，3VD组与少于3VD组。每组的FAI、MAI和HRI均有显著差异（p<0.0001）。将有显著冠状动脉疾病的组与正常组区分开的判别公式为Z = -1.049 + 0.02 [FAI] +0.08 [MAI] +0.03 [HRI]。根据该公式，敏感性为92.5%，特异性为71.5%。将多支血管病变组与少于2支血管病变组区分开的判别公式为Z = -4.731 + 0.07 [FAI] +0.106 [MAI] +0.02 [HRI]。根据该公式，敏感性为96.3%，特异性为78.8%。（摘要截取自250字）
