Rossi L, Buonanno C, Marino P, Bonaldi T, Moretti L, Zardini P
G Ital Cardiol. 1985 Apr;15(4):387-91.
In 354 patients with coronary artery disease (9 with greater than or equal to 90%, 42 with 50-75% and 303 with no left main (LM) stenosis, prevalence of ergometric criteria of severe disease was considered. In patients with LM stenosis were more frequent: work load less than or equal to 75 watt (p less than 0,001); ST depression greater than 2 mm (p less than 0,01); 3 or more leads involved (p less than 0,05); no increment of heart rate (p less than 0,01) or of blood pressure (p less than 0.01). Work load had the best predictive value (30%) of LM stenosis, associated with a reasonable sensitivity (55%). Combination ST depression + heart rate or work load + blood pressure had a predictive value of 100%, but minimal sensitivity (8%). In detecting greater than or equal to 90% LM stenosis heart rate had the best predictive value (13%), associated with high sensitivity (78%). Presence of 2 any criteria could detect all greater than or equal to 90% LM stenosis (sensitivity 100%, predictive value 11%). ST depression + heart rate had a predictive value of 100% and a sensitivity of 44%. It is concluded that no single or associated exercise variable has both high sensitivity and high predictive value of LM stenosis.
在354例冠心病患者中（9例左主干狭窄≥90%，42例狭窄50%-75%，303例无左主干狭窄），评估了严重疾病的运动试验标准患病率。左主干狭窄患者中更常见的情况有：工作量≤75瓦（p<0.001）；ST段压低>2毫米（p<0.01）；3个或更多导联受累（p<0.05）；心率无增加（p<0.01）或血压无增加（p<0.01）。工作量对左主干狭窄的预测价值最佳（30%），伴有合理的敏感性（55%）。ST段压低+心率或工作量+血压的组合预测价值为100%，但敏感性最低（8%）。在检测左主干狭窄≥90%时，心率的预测价值最佳（13%），伴有高敏感性（78%）。出现任何2项标准可检测出所有左主干狭窄≥90%的情况（敏感性100%，预测价值11%）。ST段压低+心率的预测价值为100%，敏感性为44%。结论是，没有单一或联合的运动变量对左主干狭窄具有高敏感性和高预测价值。
