Solomon A J, Tracy C M
Division of Cardiology, Georgetown University Hospital, Washington, DC 20007-2197.
Am Heart J. 1991 Nov;122(5):1334-9. doi: 10.1016/0002-8703(91)90574-2.
The ability to noninvasively detect coronary artery disease (CAD) in patients undergoing diagnostic cardiac catheterization was studied using a signal-averaged electrocardiogram. An initial study of 13 patients revealed that a QRS duration greater than or equal to 100 msec, a root mean square voltage in the terminal 40 msec of the QRS less than 50 microV, and a low amplitude signal (LAS) duration greater than 28 msec were suggestive of CAD. These parameters were then used prospectively to examine 40 consecutive patients with chest pain of undetermined etiology referred for cardiac catheterization. Patients with CAD had significantly longer filtered QRS and LAS durations and lower root mean square voltages compared with patients without CAD. The sensitivity, specificity, and positive predictive value of a single parameter ranged from 62% to 76%, 74% to 89%, and 75% to 87%, respectively. Thus the signal-averaged electrocardiogram may be a useful tool in evaluating patients for the presence of CAD.
利用信号平均心电图对接受诊断性心导管检查的患者进行无创检测冠状动脉疾病（CAD）的能力进行了研究。对13例患者的初步研究显示，QRS时限大于或等于100毫秒、QRS终末40毫秒的均方根电压小于50微伏以及低振幅信号（LAS）时限大于28毫秒提示CAD。然后前瞻性地使用这些参数检查40例因病因不明的胸痛而转诊进行心导管检查的连续患者。与无CAD的患者相比，CAD患者的滤波QRS和LAS时限明显更长，均方根电压更低。单个参数的敏感性、特异性和阳性预测值分别为62%至76%、74%至89%和75%至87%。因此，信号平均心电图可能是评估患者是否存在CAD的有用工具。
