Visser C A, van der Wieken R L, Kan G, Lie K I, Busemann-Sokele E, Meltzer R S, Durrer D
Am Heart J. 1983 Sep;106(3):528-34. doi: 10.1016/0002-8703(83)90697-x.
Two-dimensional echocardiography (2DE) was performed during 30-degree left lateral decubitus bicycle exercise in 52 patients who underwent cardiac catheterization for suspected coronary artery disease (CAD). Adequate echocardiograms were obtained in 39 patients (75%). Thirty-five of these patients underwent radionuclide angiography (RNA) with the same exercise protocol as for echocardiography. Exercise-induced or increased initial asynergy was considered to be a positive test by both 2DE and RNA. Echocardiographic, scintigraphic, and coronary angiographic data were compared to each other. Significant CAD (greater than 50% luminal obstruction) was present in 26 patients (66%). One of 15 patients with exercise-induced asynergy by 2DE had no CAD. Six 2DE and two RNA studies during exercise were falsely negative, sensitivity 76% versus 91%. Inclusion of RNA ejection fraction data would increase the sensitivity but decrease the specificity of RNA. Exercise-induced septal asynergy was far more frequently present by 2DE than by RNA (11 versus 6) in the 17 patients who had exercise-induced anterior asynergy by both methods. We conclude that it was possible to perform exercise 2DE in 75% of our patients. Exercise-induced asynergy on 2DE was specific (92%) for CAD. The sensitivity of 2DE in detecting CAD was less than that of RNA.
对52例因疑似冠状动脉疾病（CAD）而接受心导管检查的患者，在左侧卧位30度进行二维超声心动图（2DE）检查，同时进行踏车运动。52例患者中有39例（75%）获得了满意的超声心动图图像。其中35例患者按照与超声心动图相同的运动方案进行了放射性核素血管造影（RNA）检查。运动诱发或初始无运动增强被2DE和RNA均视为阳性试验。对超声心动图、闪烁显像和冠状动脉造影数据进行相互比较。26例患者（66%）存在显著CAD（管腔阻塞大于50%）。2DE检查运动诱发无运动的15例患者中1例无CAD。运动期间6例2DE和2例RNA检查结果为假阴性，2DE敏感性为76%，RNA为91%。纳入RNA射血分数数据会提高RNA的敏感性但降低其特异性。在两种方法均显示运动诱发前壁无运动的17例患者中，2DE显示运动诱发的室间隔无运动远比RNA常见（分别为11例和6例）。我们得出结论，75%的患者可以进行运动2DE检查。2DE上运动诱发的无运动对CAD具有特异性（92%）。2DE检测CAD的敏感性低于RNA。
