From the Department of Cardiology, Sisters of Charity University Hospital Centre, Vinogradska cesta 29, 10 000 Zagreb, Croatia.
School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia.
QJM. 2017 Feb 1;110(2):89-95. doi: 10.1093/qjmed/hcw162.
To investigate the effectiveness of cardiogoniometry, a novel, non-invasive method, in diagnosing coronary artery disease (CAD) in women and compare it with exercise-ECG test, by using coronary angiography as a reference method.
It was a single-centre, case-series study including consecutive female patients with stable angina pectoris (AP) undergoing coronary angiography. Exercise-ECG test, done according to the Bruce protocol, and cardiogoniometry were obtained prior to coronary angiography. Clinically significant CAD has been defined as one or more coronary lesions with >70% stenosis.
Study included 114 consecutive female patients with median age of 64.0 (58.0-71.0) years, out of which 32 (28.1%) had CAD. Cardiogoniometry yielded a total accuracy of 74.6% with a sensitivity of 75.0% (95% CI 56.6-88.5) and specificity of 74.4% (95% CI 63.6-83.4). Exercise-ECG test yielded a total accuracy of 45.1% with a sensitivity of 68.1% (95% CI 42.7-83.6) and specificity 36.6% (95% CI 25.2-50.3). Cardiogoniometry showed higher accuracy than exercise-ECG test ( P < 0.001). Pathological cardiogoniometry was associated with almost nine times higher risk for CAD (OR 8.7, 95%CI 3.4-22.3, P < 0.001), which remained significant after adjustment for age, and hypokinesia.
Cardiogoniometry is a non-invasive, easy-to-use and free-of-risk method which showed high effectiveness in diagnosing stable CAD in women and superior to exercise-ECG test. Cardiogoniometry could be introduced as a part of the diagnostic algorithm of screening women for stable CAD and is suitable for use in the primary setting, especially in women unable to undergo stress-testing.
通过冠状动脉造影作为参考方法，研究一种新的无创方法——心音图测量法在诊断女性冠心病（CAD）方面的有效性，并与运动心电图测试进行比较。
这是一项单中心、病例系列研究，纳入了 114 名连续接受冠状动脉造影的稳定型心绞痛（AP）女性患者。根据布鲁斯方案进行运动心电图测试和心音图测量。临床显著 CAD 定义为一个或多个狭窄程度超过 70%的冠状动脉病变。
研究纳入了 114 名连续的女性患者，中位年龄为 64.0（58.0-71.0）岁，其中 32 名（28.1%）患有 CAD。心音图测量的总准确率为 74.6%，灵敏度为 75.0%（95%CI 56.6-88.5），特异性为 74.4%（95%CI 63.6-83.4）。运动心电图测试的总准确率为 45.1%，灵敏度为 68.1%（95%CI 42.7-83.6），特异性为 36.6%（95%CI 25.2-50.3）。心音图测量的准确率高于运动心电图测试（P<0.001）。病理性心音图与 CAD 的风险增加近九倍相关（OR 8.7，95%CI 3.4-22.3，P<0.001），在校正年龄和运动减弱后仍然显著。
心音图测量法是一种无创、易用、无风险的方法，在诊断女性稳定型 CAD 方面具有较高的有效性，优于运动心电图测试。心音图测量法可作为女性稳定型 CAD 筛查诊断算法的一部分，适用于初级医疗机构，特别是无法进行应激测试的女性。
