Schreck D M, Ng L, Schreck B S, Zacharias D, Grunau C F
Ann Emerg Med. 1986 Aug;15(8):897-900. doi: 10.1016/s0196-0644(86)80671-0.
Despite the common use of the standard 12-lead ECG, its reliability as an indicator of coronary artery disease (CAD) is poor. The normal ECG is falsely negative in more than 50% of angiographically proven CAD. The waveform of the standard ECG, however, can be transformed mathematically by nonlinear signal transformation to enhance its interpretation by computer. Using such a process it is possible that abnormalities can be identified in "normal" ECGs that can be correlated with CAD, thus identifying high-risk patients. A computer template that represents grouped data of normal ECGs for patients who also have normal coronary angiography was developed. Unblinded, preliminary testing of the template on normal ECGs of 107 white patients who had normal or abnormal coronary angiograms was performed. The process identified presence or absence of CAD with 82% specificity and 71% sensitivity for 53 women, and with 82% specificity and 86% sensitivity for 54 men. These preliminary results are promising, but further refinement of the templates is required and blinded studies with larger numbers and varieties of patients are needed.
尽管标准12导联心电图被广泛使用，但其作为冠状动脉疾病（CAD）指标的可靠性较差。在超过50%经血管造影证实患有CAD的患者中，正常心电图呈假阴性。然而，标准心电图的波形可以通过非线性信号变换进行数学转换，以增强计算机对其的解读。通过这样的过程，有可能在“正常”心电图中识别出与CAD相关的异常，从而识别出高危患者。开发了一个计算机模板，该模板代表了冠状动脉造影也正常的患者的正常心电图分组数据。对107名冠状动脉造影正常或异常的白人患者的正常心电图进行了非盲法初步模板测试。该过程对53名女性识别CAD存在与否的特异性为82%，敏感性为71%；对54名男性识别CAD存在与否的特异性为82%，敏感性为86%。这些初步结果很有前景，但需要进一步完善模板，并且需要对更多数量和种类的患者进行盲法研究。
