McNeer J F, Margolis J R, Lee K L, Kisslo J A, Peter R H, Kong Y, Behar V S, Wallace A G, McCants C B, Rosati R A
Circulation. 1978 Jan;57(1):64-70. doi: 10.1161/01.cir.57.1.64.
A cohort of 1472 patients who underwent both exercise stress testing and coronary angiography within six weeks was examined. The data indicated that a combination of exercise parameters is both diagnostically and prognostically important. Almost all patients (greater than 97%) who had positive exercise tests at Stage I or Stage II had significant coronary artery disease. More than half of these (greater than 60%) had three vessel disease and over 25% had significant narrowing (greater than 50%) of the left main coronary artery. Patients who achieved Stage IV or greater exercise durations with either negative or indeterminate ST-segment response had less than a 15% prevalence of three vessel disease and less than a 1% prevalence of left main coronary artery disease. A low risk subgroup (75% of all non-operated patients) was identified with a twelve month survival greater than 99%. A high risk subgroup (11% of all nonoperated patients) was identified with a twelve month survival of less than 85%. The exercise test is a noninvasive, reproducible method to assess the presence and extent of anatomic disease and the prognosis when significant disease has been defined. It should be used in conjunction with other noninvasive tests to determine optimal management in patients evaluated for ischemic heart disease.
对一组1472名在六周内同时接受运动负荷试验和冠状动脉造影的患者进行了检查。数据表明，运动参数的组合在诊断和预后方面都很重要。几乎所有（超过97%）在I期或II期运动试验呈阳性的患者都患有严重冠状动脉疾病。其中一半以上（超过60%）患有三支血管病变，超过25%的患者左主干冠状动脉有明显狭窄（超过50%）。在运动持续时间达到IV期或更长时间且ST段反应为阴性或不确定的患者中，三支血管病变的患病率低于15%，左主干冠状动脉疾病的患病率低于1%。确定了一个低风险亚组（占所有未手术患者的75%），其十二个月生存率大于99%。确定了一个高风险亚组（占所有未手术患者的11%），其十二个月生存率低于85%。运动试验是一种评估解剖学疾病的存在和程度以及在已确定存在重大疾病时的预后的非侵入性、可重复的方法。它应与其他非侵入性检查结合使用，以确定对疑似缺血性心脏病患者的最佳治疗方案。
