Deckers J W, Rensing B J, Tijssen J G, Vinke R V, Azar A J, Simoons M L
Thoraxcenter, Academic Hospital Rotterdam, Dijkzigt, The Netherlands.
Br Heart J. 1989 Dec;62(6):438-44. doi: 10.1136/hrt.62.6.438.
The diagnostic accuracy of the following methods of analysing exercise tests were evaluated: (a) the cumulative area of ST segment depression during exercise normalised for workload and heart rate (exercise score); (b) discriminant analysis of electrocardiographic exercise variables, workload, and symptoms; and (c) ST segment amplitude changes during exercise adjusted for heart rate. Three hundred and forty five men without a history of myocardial infarction were studied. One hundred and twenty three were apparently healthy. Less than half (170) had coronary artery disease. All had a normal electrocardiogram at rest. A Frank lead electrocardiogram was computer processed during symptom limited bicycle ergometry. The accuracy of the exercise score (a) was low (sensitivity 67%, specificity 90%). Discriminant analysis (b) and ST segment amplitude changes adjusted for heart rate (c) had excellent diagnostic characteristics (sensitivity 80%, specificity 90%), which were little affected by concomitant use of beta blockers. Both methods seem well suited for diagnostic application in clinical practice.
(a) 根据工作量和心率进行标准化的运动期间ST段压低的累积面积（运动评分）；(b) 对心电图运动变量、工作量和症状进行判别分析；以及(c) 根据心率调整的运动期间ST段幅度变化。对345名无心肌梗死病史的男性进行了研究。其中123名明显健康。不到一半（170名）患有冠状动脉疾病。所有人静息心电图均正常。在症状受限的踏车运动试验期间对Frank导联心电图进行计算机处理。运动评分(a)的准确性较低（敏感性67%，特异性90%）。判别分析(b)和根据心率调整的ST段幅度变化(c)具有出色的诊断特征（敏感性80%，特异性90%），同时使用β受体阻滞剂对其影响很小。这两种方法似乎都非常适合在临床实践中用于诊断。
