Rijneke R D, Ascoop C A, Talmon J L
Circulation. 1980 Apr;61(4):671-8. doi: 10.1161/01.cir.61.4.671.
Conventional exercise electrocardiographic criteria usually involve patterns with a horizontal or downsloping ST segment. In the present study we present criteria based on upsloping ST segments and compared these criteria with the conventional criteria. Using upsloping ST-segment criteria, the amount of ST-segment depression at 80 msec after the end of the QRS complex is used as a parameter (ST criterion E, with a depression of 100 mV, and ST criterion F, with a depression of 200 mV). In the graded exercise test a bicycle ergometer was used. The ECG leads were CM5 and CC5. The results of exercise electrocardiography were compared with the findings from coronary arteriography. In 623 selected patients (565 males and 58 females), application of conventional ST criteria gave a sensitivity of 56% and a specificity of 94%; with application of the ST criteria E or F, sensitivity was 75% and specificity 90%. In the 58 females use of these new criteria resulted in a sensitivity of 76% and specificity of 88%. Ninety-three patients (15%) could be classified as positive exercise responders by the sole presence of an upsloping ST segment (type E or F). Sixty-eight percent of the patients with type E and 75% with type F had two- or three-vessel disease (coronary obstructions greater their or equal to 50%). We conclude that ST criteria based on upsloping ST segments significantly increase the diagnostic yield of the exercise ECG.
传统的运动心电图标准通常涉及水平或下斜型ST段模式。在本研究中，我们提出了基于上斜型ST段的标准，并将这些标准与传统标准进行了比较。使用上斜型ST段标准时，QRS波群结束后80毫秒时的ST段压低幅度用作参数（ST标准E，压低100伏；ST标准F，压低200伏）。在分级运动试验中使用了自行车测力计。心电图导联为CM5和CC5。将运动心电图结果与冠状动脉造影结果进行比较。在623例选定患者（565例男性和58例女性）中，应用传统ST标准时敏感性为56%，特异性为94%；应用ST标准E或F时，敏感性为75%，特异性为90%。在58例女性中，使用这些新标准的敏感性为76%，特异性为88%。仅因存在上斜型ST段（E型或F型），93例患者（15%）可被归类为运动阳性反应者。E型患者中有68%、F型患者中有75%患有双支或三支血管病变（冠状动脉阻塞大于或等于50%）。我们得出结论，基于上斜型ST段的ST标准显著提高了运动心电图的诊断率。
