Weiner D A
J Am Coll Cardiol. 1985 Sep;6(3):502-9. doi: 10.1016/s0735-1097(85)80105-4.
To determine the diagnostic accuracy of cardiokymography, recorded 2 to 3 minutes after exercise, 617 patients undergoing cardiac catheterization were evaluated from 12 participating centers using a standardized protocol. Adequate cardiokymographic tracings, which were obtained in 82% of patients, were dependent on the skill of the operator and on certain patient characteristics. Of the 327 patients without prior myocardial infarction who had technically adequate cardiokymographic and electrocardiographic tracings, 166 (51%) had coronary disease. Both the sensitivity and specificity of cardiokymography (71 and 88%, respectively) were significantly greater than the values for the exercise electrocardiogram (61 and 76%, respectively, both p less than 0.01). Coronary artery disease and multivessel disease were present in 98 and 68%, respectively, of the 70 patients with concordantly positive cardiokymographic and electrocardiographic results, and in 15 and 5%, respectively, of the 132 patients with concordantly negative test results (p less than 0.001). Cardiokymography was most helpful in those patients in whom the posttest probability of coronary disease was between 21 and 72% after exercise electrocardiography. In these patients a concordantly positive cardiokymographic result increased the probability of coronary disease to between 67 and 100%, whereas a negative response decreased it to between 12 and 15%. In the subgroup of 102 patients undergoing concomitant exercise thallium testing, the sensitivity and specificity for the thallium scintigraphy (81 and 80%, respectively) were similar to the values for cardiokymography (72 and 84%, respectively; differences not significant). Thus, cardiokymography performed during exercise testing improves the diagnostic accuracy of the electrocardiographic response and provides an additional and cost-effective indicator of myocardial ischemia.
为确定运动后2至3分钟记录的心动记波图的诊断准确性，采用标准化方案对来自12个参与中心的617例接受心脏导管检查的患者进行了评估。82%的患者获得了足够的心动记波图记录，这取决于操作者的技术和某些患者特征。在327例无既往心肌梗死且心动记波图和心电图记录技术上足够的患者中，166例（51%）患有冠心病。心动记波图的敏感性和特异性（分别为71%和88%）显著高于运动心电图的值（分别为61%和76%，p均小于0.01）。心动记波图和心电图结果均为阳性的70例患者中，分别有98%和68%存在冠状动脉疾病和多支血管疾病；在132例结果均为阴性的患者中，分别有15%和5%存在上述情况（p小于0.001）。心动记波图对运动心电图检查后冠心病患病后验概率在21%至72%之间的患者最有帮助。在这些患者中，心动记波图结果均为阳性使冠心病患病概率增加至67%至100%，而阴性结果则将其降至12%至15%。在102例同时进行运动铊试验的患者亚组中，铊闪烁显像的敏感性和特异性（分别为81%和80%）与心动记波图的值（分别为72%和84%；差异无统计学意义）相似。因此，运动试验期间进行的心动记波图检查提高了心电图反应的诊断准确性，并提供了一个额外的且具有成本效益的心肌缺血指标。
