Douard H, Pic A, Broustet J P
Arch Mal Coeur Vaiss. 1985 Mar;78(3):415-9.
Variations in the amplitude of the Q wave in lead CM5 during computerised exercise stress testing were studied in 220 patients and compared with the results of coronary angiography. The average amplitude of the Q wave increases during exercise in athletes (n = 30) from 3 +/- 2.75 mm to 4.72 +/- 2.35 mm (p less than 0.01), and in subjects without coronary artery disease (n = 49) from 0.92 +/- 1.05 mm to 1.75 +/- 1.62 mm (p less than 0.01). The Q wave did not vary significantly during exercise in patients with coronary disease but without previous infarction (n = 88) (0.70 +/- 0.91 mm to 0.62 +/- 0.85 mm). The amplitude of the Q wave did tend to decrease in patients with previous myocardial infarction (n = 83) from 1.96 +/- 2.05 mm to 1.35 +/- 1.26 mm (p less than 0.05). It is therefore possible to define a new diagnostic criterion of coronary disease: "the exercise stress test is said to be positive (delta q+) when the Q wave tends to decrease or remains stable during exercise, and negative (delta q-) when the Q wave amplitude increases during exercise". This criterion was tested in 49 normal and 83 coronary patients without infarction. The sensitivity (Se) was 79 p. 100 and the specificity (Sp) 65 p. 100, so correctly classifying 74 p. 100 of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
对220例患者在计算机化运动应激试验期间CM5导联Q波振幅的变化进行了研究，并与冠状动脉造影结果进行了比较。运动员（n = 30）运动期间Q波平均振幅从3±2.75mm增加到4.72±2.35mm（p＜0.01），无冠状动脉疾病的受试者（n = 49）从0.92±1.05mm增加到1.75±1.62mm（p＜0.01）。冠心病但无既往梗死的患者（n = 88）运动期间Q波无显著变化（0.70±0.91mm至0.62±0.85mm）。既往有心肌梗死的患者（n = 83）Q波振幅确实有降低趋势，从1.96±2.05mm降至1.35±1.26mm（p＜0.05）。因此，有可能定义一种新的冠心病诊断标准：“运动应激试验时，若Q波在运动期间趋于降低或保持稳定，则称为阳性（δq+）；若Q波振幅在运动期间增加，则称为阴性（δq-）”。该标准在49例正常人和83例无梗死的冠心病患者中进行了测试。敏感性（Se）为79%，特异性（Sp）为65%，正确分类患者的比例为74%。（摘要截短至250字）
