Carboni G P, Celli P, D'Ermo M, Santoboni A, Zanchi E
Int J Cardiol. 1985 Sep;9(1):91-101. doi: 10.1016/0167-5273(85)90407-3.
To enhance diagnostic accuracy in coronary artery disease, cardiac cinefluoroscopy for the detection of coronary artery calcification was combined with exercise test and ambulatory ST-segment monitoring in 104 symptomatic patients before they underwent coronary angiography. In 44 patients with typical angina the combination of the three noninvasive tests and the exercise test alone both detected 92% of subjects with clinically important coronary artery disease. In 60 patients with atypical angina, the combination of the three noninvasive tests screened 77% of the subjects with clinically important coronary artery disease versus 43% after exercise test only (P less than 0.001). The exercise electrocardiogram was false negative in a substantial number of patients with atypical angina due to the presence of a good coronary reserve or to a daily circadian variation in the tone of the coronary arteries. Under these circumstances, cardiac cinefluoroscopy gave additional anatomic information to the physiological assessment of ischemia provided by the exercise test and ambulatory ST-segment monitoring. Our study suggests that the combination of cardiac cinefluoroscopy with other noninvasive tests may be particularly useful in screening atypically symptomatic populations.
为提高冠心病的诊断准确性，在104例有症状的患者接受冠状动脉造影之前，将用于检测冠状动脉钙化的心脏荧光电影摄影与运动试验及动态ST段监测相结合。在44例典型心绞痛患者中，三种非侵入性检查联合应用与单独运动试验均检测出92%有临床意义的冠状动脉疾病患者。在60例非典型心绞痛患者中，三种非侵入性检查联合应用筛查出77%有临床意义的冠状动脉疾病患者，而仅运动试验后为43%（P<0.001）。由于存在良好的冠状动脉储备或冠状动脉张力的日常昼夜变化，相当数量的非典型心绞痛患者运动心电图呈假阴性。在这种情况下，心脏荧光电影摄影为运动试验和动态ST段监测所提供的缺血生理评估增加了解剖学信息。我们的研究提示，心脏荧光电影摄影与其他非侵入性检查联合应用在筛查非典型症状人群中可能特别有用。
