Huang Qiong, Wang Junhong, Li Dianfu, Zhao Jihong, Feng Xiangjun, Zhou Ningtian
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210000, P.R. China.
Department of Geriatric General Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650000, P.R. China.
Exp Ther Med. 2021 Feb;21(2):130. doi: 10.3892/etm.2020.9562. Epub 2020 Dec 10.
Myocardial ischemia (MI) has the highest mortality rate in the world. Traditional noninvasive MI examinations include exercise electrocardiography tests (EETs) and stress echocardiography (SE). Treadmill and dobutamine tests are commonly used as stress protocols. In the present study, 278 patients with suspected MI were examined, 66 of whom were diagnosed with MI and 212 did not show evidence of MI by coronary angiography (CAG)/coronary CT angiography (CCTA). All patients underwent clinical EET and SE evaluations prior to CAG/CCTA. All groups were compared based on specific clinical parameters including age, sex, blood pressure, heart rate, blood oxygen saturation, underlying conditions and ejection fraction/fraction shortening. The data indicated superior diagnostic efficiency of the combined EET+SE method for the diagnosis of suspected MI compared with either EET or SE alone. The sensitivity/specificity/positive predictive value and negative predictive value for detecting MI were excellent compared with those of traditional examinations. The diagnostic efficiency of the combination analysis may reduce the prevalence of MI and medical costs. The present study provided novel insight for the development of methods that may be used for MI detection and prediction.
心肌缺血(MI)在全球具有最高的死亡率。传统的无创心肌缺血检查包括运动心电图测试(EETs)和负荷超声心动图(SE)。跑步机试验和多巴酚丁胺试验通常用作负荷方案。在本研究中,对278例疑似心肌缺血患者进行了检查,其中66例被诊断为心肌缺血,212例通过冠状动脉造影(CAG)/冠状动脉CT血管造影(CCTA)未显示心肌缺血证据。所有患者在进行CAG/CCTA之前均接受了临床EET和SE评估。根据包括年龄、性别、血压、心率、血氧饱和度、基础疾病和射血分数/缩短分数在内的特定临床参数对所有组进行比较。数据表明,与单独的EET或SE相比,联合EET+SE方法对疑似心肌缺血的诊断具有更高的诊断效率。与传统检查相比,检测心肌缺血的敏感性/特异性/阳性预测值和阴性预测值都非常出色。联合分析的诊断效率可能会降低心肌缺血的患病率和医疗成本。本研究为开发可用于心肌缺血检测和预测的方法提供了新的见解。