Crawford M H
Department of Medicine, University of New Mexico School of Medicine, Albuquerque 87131.
Circulation. 1991 Sep;84(3 Suppl):I50-1.
Noninvasive tests have greatly improved in their ability to diagnose coronary artery disease. In addition, new testing modalities have been added to our armamentarium. However, no test is clearly superior to all others in every clinical circumstance. Moreover, none have been shown to provide sensitivities and specificities consistently above 90%. Therefore, their use for diagnostic purposes in populations with a lower prevalence of disease is only of moderate value. Conversely, for the assessment of the functional significance of coronary artery disease or prognosis in patients with ischemic heart disease, the addition of noninvasive imaging modalities to exercise testing is of high value.
无创检测在诊断冠状动脉疾病的能力方面有了很大提高。此外,新的检测方式已被纳入我们的手段。然而,在每种临床情况下,没有一种检测方法明显优于所有其他方法。而且,没有一种检测方法被证明能始终提供高于90%的敏感性和特异性。因此,它们在疾病患病率较低的人群中用于诊断目的的价值仅为中等。相反,对于评估冠状动脉疾病的功能意义或缺血性心脏病患者的预后,在运动试验中增加无创成像方式具有很高的价值。