Yang Hongbo, Huang Zheyong, Lou Yi, Shen Yunli, Qian Juying, Ge Junbo
Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China. Email:
Chin Med J (Engl). 2014;127(4):742-6.
Clinical meaning of recovery phase limited ST segment depression of a treadmill exercise test is controversial. The aim of this study was to re-assess the diagnostic and prognostic value of ST segment depression during the recovery phase with the active phase of a treadmill exercise test in suspected coronary artery disease patients.
Clinical, exercise and angiographic data were retrospectively collected from 602 patients in the study. Five hundred and seventy-six patients developed ST segment depression during the active phase of the treadmill exercise test (group 1) and 26 patients developed ST segment depression only during the recovery phase (group 2).
With similar major clinical features, the prevalence of significant coronary artery stenosis and average Gensini scores were lower in the recovery phase-limited depression patients (group 2 vs. group 1, 50.0% vs. 66.9%, P = 0.031 and group 2 vs. group 1, 1.5 vs. 8.5, P = 0.04). At a median follow up of 50.9 months for 22 group 2 and 34.8 months for 438 group 1 patients, the prevalence of total cardiac events was higher in group 1 than in group 2 patients (RR 1.60, 95% CI 1.00-2.54, P = 0.049).
The present study provides preliminary evidence that the diagnostic and prognostic value of recovery phaselimited ST segment depression of treadmill exercise test is limited.
平板运动试验恢复阶段局限性ST段压低的临床意义存在争议。本研究的目的是在疑似冠心病患者中，重新评估平板运动试验恢复阶段与运动阶段ST段压低的诊断和预后价值。
回顾性收集本研究中602例患者的临床、运动及血管造影数据。576例患者在平板运动试验运动阶段出现ST段压低（1组），26例患者仅在恢复阶段出现ST段压低（2组）。
在主要临床特征相似的情况下，恢复阶段局限性压低患者（2组与1组相比，50.0%对66.9%，P = 0.031；2组与1组相比，1.5对8.5，P = 0.04）的显著冠状动脉狭窄患病率和平均Gensini评分较低。对22例2组患者和438例1组患者分别进行了中位随访50.9个月和34.8个月，1组患者的总心脏事件患病率高于2组患者（RR 1.60，95%CI 1.00 - 2.54，P = 0.049）。
本研究提供了初步证据，表明平板运动试验恢复阶段局限性ST段压低的诊断和预后价值有限。
