一种创新的非侵入性呼吸应激测试显示存在严重冠状动脉疾病。

An innovative noninvasive respiratory stress test indicates significant coronary artery disease.

作者信息

Waksman Ron, Sushinsky Steven, Okubagzi Petros, Landry Patricia, Torguson Rebecca, Bui Anh, Shiyovich Arthur, Scharf Steven M, Katz Amos

机构信息

Division of Cardiology, Washington Hospital Center, Washington, DC, USA.

出版信息

Cardiovasc Revasc Med. 2010 Jan-Mar;11(1):20-8. doi: 10.1016/j.carrev.2009.09.005.

DOI:10.1016/j.carrev.2009.09.005

PMID:20129357

Abstract

BACKGROUND

Respiratory maneuvers can uncover manifestations of myocardial ischemia. Some pulse wave characteristics are strongly associated with significant coronary artery disease (S-CAD). An innovative test using the respiratory stress response (RSR) has been developed for the detection of S-CAD. It is based on spectral analysis of finger pulse wave oscillations measured by photoplethysmography during deep, paced breathing at a rate of six breaths per minute (0.1 Hz) over 70 s.

METHODS

RSR was assessed, prior to the procedure, in 150 consecutive patients referred for coronary angiography. It was calculated by analyzing the relative spectral power of the respiratory peak area at 0.1 Hz, using proprietary software. The coronary angiograms were analyzed by quantitative coronary angiography by 1 cardiologist who was blinded to the RSR results. S-CAD was defined as luminal stenosis >70% of > or = 1 coronary artery with a diameter > or = 2 mm, or left main stenosis >50%. A valid RSR was obtained in 150 of 153 patients (98%) with a mean age of 58.7 + or - 10.6 years (67% males).

RESULTS

S-CAD was found in 36 patients (24%). S-CAD patients had significantly lower RSR compared to patients without S-CAD (6.7% + or - 5.1 vs. 17.4% + or - 10.6; P<.001, respectively). Multivariate logistic regression analysis, adjusted for known CAD risk factors, showed that RSR is a strong independent indicator of S-CAD (odds ratio 41.2, 95% CI 12.2-139.3; P<.001).

CONCLUSION

The innovative RSR test is a simple, noninvasive bedside or office-based tool for the detection of S-CAD.

摘要

背景

呼吸动作可揭示心肌缺血的表现。一些脉搏波特征与严重冠状动脉疾病（S-CAD）密切相关。一种利用呼吸应激反应（RSR）的创新检测方法已被开发用于检测S-CAD。它基于在每分钟6次呼吸（0.1Hz）的深度、有节奏呼吸过程中，通过光电容积描记法测量的手指脉搏波振荡的频谱分析，持续70秒。

方法

在进行冠状动脉造影的150例连续患者中，术前评估RSR。使用专用软件通过分析0.1Hz呼吸峰值区域的相对频谱功率来计算RSR。由1名对RSR结果不知情的心脏病专家通过定量冠状动脉造影分析冠状动脉造影。S-CAD定义为1条或多条直径≥2mm的冠状动脉管腔狭窄>70%，或左主干狭窄>50%。153例患者中有150例（98%）获得了有效的RSR，平均年龄为58.7±10.6岁（67%为男性）。

结果

36例患者（24%）发现有S-CAD。与无S-CAD的患者相比，S-CAD患者的RSR显著更低（分别为6.7%±5.1与17.4%±10.6；P<0.001）。在对已知CAD危险因素进行校正的多因素逻辑回归分析中，显示RSR是S-CAD的一个强有力的独立指标（优势比41.2，95%CI 12.2-139.3；P<0.001）。