Department of Cardiology, Aviation General Hospital, An Ding Men Wai Bei Yuan Road 3, Beijing 100012, China,
Cell Biochem Biophys. 2013 Jan;65(1):69-76. doi: 10.1007/s12013-012-9401-y.
The aim of this study was to determine the diagnostic value of treadmill exercise test (TET) in patients with coronary heart disease (CHD) by comparing the diagnostic conclusions with coronary angiography (CAG). Patients (445) with CHD and suspected CHD underwent TET and CAG, and the corresponding diagnostic conclusions were compared. (1) Out of the 200 cases that had the positive result with TET, 150 cases had been diagnosed CHD by means of CAG; Out of the 245 cases that had the negative result during TET, only 39 cases had been diagnosed CHD by means of CAG. The sensitivity, specificity, positive predictive value, negative predictive value, the false positive incidence, the false negative incidence, and agreement rate in diagnosis of CHD by TET were 79.36, 80.40, 75.00, 84.08, 25.00, 15.92, and 80.00 %, respectively. The patients with multi-vessel disease had a higher positive rate of TET as compared with those with single-vessel disease (P < 0.05). (2) The parameters for 189 cases positive CAG (patients diagnosed CHD by CAG) and 256 cases negative CAG (the control group), including the general exercise time, peak heart rate, and the beginning time of ST depression, were lower than that of control group (P < 0.05). However, the extent of ST depression and duration of ST depression were higher in these patients than in the control group (P < 0.05). (3) 189 cases positive CAG, include 87 cases of single coronary artery and 102 cases of binary or more coronary arteries (the control group). The parameters, including the general exercise time, peak heart rate, and the beginning time of ST depression, were lower than the control group (P < 0.05). However, the extent of ST depression and duration of ST depression were higher in these patients than the control group (P < 0.05). The TET is valuable for noninvasive diagnosis of CHD, especially for patients with multi-vessel disease.
本研究旨在通过比较平板运动试验(TET)与冠状动脉造影(CAG)的诊断结论,确定 TET 在冠心病(CHD)患者中的诊断价值。将 445 例 CHD 可疑患者行 TET 和 CAG,并对相应的诊断结论进行比较。(1)TET 阳性 200 例中,CAG 诊断 CHD 者 150 例;TET 阴性 245 例中,CAG 诊断 CHD 者 39 例。TET 诊断 CHD 的灵敏度、特异度、阳性预测值、阴性预测值、假阳性率、假阴性率和符合率分别为 79.36%、80.40%、75.00%、84.08%、25.00%、15.92%和 80.00%。多支血管病变患者 TET 阳性率高于单支血管病变(P<0.05)。(2)189 例 CAG 阳性(CAG 诊断 CHD 者)和 256 例 CAG 阴性(对照组)患者的一般运动时间、最大心率、ST 段压低起始时间等参数均低于对照组(P<0.05)。但 ST 段压低程度和 ST 段压低持续时间均高于对照组(P<0.05)。(3)189 例 CAG 阳性者中,单支血管病变 87 例,双支或多支血管病变 102 例(对照组)。一般运动时间、最大心率、ST 段压低起始时间等参数均低于对照组(P<0.05)。但 ST 段压低程度和 ST 段压低持续时间均高于对照组(P<0.05)。TET 对 CHD 的无创诊断具有重要价值,尤其是对多支血管病变患者。