Hosokawa Joji, Shen Joseph T, Imhoff Michael
From the Tokyo Heart Center, Kita-shinagawa, Shinagawa, Tokyo, Japan.
Congest Heart Fail. 2008 Sep-Oct;14(5):251-60. doi: 10.1111/j.1751-7133.2008.00003.x.
To assess the sensitivity and specificity of a new computer-enhanced resting electrocardiographic analysis device for the detection of coronary stenosis, 189 patients (aged 61.3+/-12.9 years, 57 women) scheduled for coronary angiography from 4 Asian centers were included in an observational study. Angiographic results were independently classified for hemodynamically relevant stenosis by 2 angiographers. The device calculated a severity score from 0 to 20. The score was significantly higher for patients with coronary stenosis (5.4+/-1.8 vs 1.7+/-2.1). The study device (cutoff 4.0) identified 73 of 77 patients with stenosis (sensitivity 94.8%, specificity 86.6%). Adjusted positive and negative predictive values were 78.4% and 97.1%, respectively (receiver operating characteristic area under the curve, 0.914 [95% confidence interval, 0.868-0.961]). Subgroup analysis showed no significant influence of sex, age, previous revascularization procedures, or participating center. The new computer-enhanced, resting electrocardiographic analysis device appears to identify patients with relevant coronary stenosis with high sensitivity and specificity.
为评估一种新型计算机增强静息心电图分析设备检测冠状动脉狭窄的敏感性和特异性,一项观察性研究纳入了来自4个亚洲中心计划接受冠状动脉造影的189例患者(年龄61.3±12.9岁,女性57例)。由2名血管造影师对血管造影结果独立进行血流动力学相关狭窄的分类。该设备计算出0至20的严重程度评分。冠状动脉狭窄患者的评分显著更高(5.4±1.8对1.7±2.1)。该研究设备(临界值4.0)在77例狭窄患者中识别出73例(敏感性94.8%,特异性86.6%)。调整后的阳性和阴性预测值分别为78.4%和97.1%(曲线下面积,0.914[95%置信区间,0.868 - 0.961])。亚组分析显示性别、年龄、既往血运重建手术或参与中心均无显著影响。这种新型计算机增强静息心电图分析设备似乎能以高敏感性和特异性识别有相关冠状动脉狭窄的患者。