Gehring J, Koenig W, Haendel M, Sund M, Mathes P
Höhenried Clinic for Cardiovascular Diseases, Bernried, FRG.
Cardiology. 1988;75(2):100-7. doi: 10.1159/000174356.
In order to determine the value of cardiokymography in detecting left ventricular (LV) anterior wall asynergies, 80 consecutive patients had a cardiokymogram (CKG) and an electrocardiogram (ECG) on the day prior to coronary angiography. Technically adequate CKGs were obtained in 72 patients (67 men and 5 women, mean age 53 +/- 6.5 years). For validation of regional contraction abnormalities, quantitative LV angiography was used. Stepwise linear discriminant analysis was applied to investigate the diagnostic power of CKG. Sensitivity of the CKG for LV anterior wall asynergy was 67.9% (ECG: 39.6%) and specificity was 68.4% (ECG: 94.7%) on the basis of 1 SD of the mean values of the radial axis shortening of a control group. For 2 SD, the sensitivity was 65.6% (ECG: 56.3%) and the specificity 47.5% (ECG: 90%). By combined testing, the specificity increased to 98.3%, whereas the sensitivity dropped to 26.9%. The improvement of the post-test likelihood for a positive ECG by a positive CKG is especially pronounced in the intermediate prevalence range, whereas for a negative ECG the post-test likelihood can be further decreased by a negative CKG in the intermediate and high prevalence range. The ECG as a single test seems to be the more appropriate noninvasive method for detecting LV anterior wall asynergies; however, the combined use of both ECG and CKG may considerably improve the diagnostic accuracy.
为了确定心脏运动X线摄影术在检测左心室（LV）前壁运动不协调方面的价值，80例连续患者在冠状动脉造影前一天进行了心脏运动X线摄影（CKG）和心电图（ECG）检查。72例患者（67例男性和5例女性，平均年龄53±6.5岁）获得了技术上合适的CKG。为了验证局部收缩异常，采用了定量左心室血管造影。应用逐步线性判别分析来研究CKG的诊断能力。基于对照组桡骨轴缩短平均值的1个标准差，CKG对LV前壁运动不协调的敏感性为67.9%（ECG：39.6%），特异性为68.4%（ECG：94.7%）。对于2个标准差，敏感性为65.6%（ECG：56.3%），特异性为47.5%（ECG：90%）。通过联合检测，特异性提高到98.3%，而敏感性降至26.9%。在中等患病率范围内，阳性CKG使阳性ECG的检测后可能性的提高尤为明显，而在中等和高患病率范围内，阴性CKG可使阴性ECG的检测后可能性进一步降低。ECG作为单一检测方法似乎是检测LV前壁运动不协调更合适的非侵入性方法；然而，ECG和CKG联合使用可能会显著提高诊断准确性。
