Atar D, Ali S, Steensgaard-Hansen F, Saunamäki K, Ramanujam P S, Egeblad H, Haunsø S
University Hospital (Rigshospitalet), Department of Medicine, Copenhagen, Denmark.
Int J Card Imaging. 1995 Mar;11(1):1-7. doi: 10.1007/BF01148948.
The aim of the study was to assess the diagnostic value of bicycle exercise echocardiography using quantitative coronary arteriography as a reference. Exercise echocardiography was performed in 70 consecutive patients referred for coronary angiography. Digital loops were obtained at rest, peak, and immediately after exercise in the standard views (parasternal long and short axis, apical two and four chamber views). Wall motion analysis was made on the basis of the 16 segment model, scoring each segment from 3 (hyperkinesia) to -1 (hypokinesia). Exercise echocardiography was considered positive when wall motion in at least one segment decreased at least one score from rest to peak or post exercise. Cinefilms were evaluated using automated quantitative coronary arteriography software. Transstenotic pressure gradients were calculated based on flow assumptions at the maximal stenosis flow reserve. Pressure losses > 30 mmHg and quantitatively measured percent diameter stenosis of > 50% were considered clinically significant. Stenoses in the equivocal range of 40-69% were subjected to separate analysis. Exercise echocardiography was superior to exercise-induced ST-segment depression in the diagnosis of coronary artery disease. In the overall sample of 70 patients, the sensitivity of exercise echocardiography against percent diameter stenosis was 84%, against pressure gradient 86%. The specificity against these two parameters was 86% and 84%, respectively. When analysing the subgroup of 40-69% stenoses (N = 14), sensitivity of exercise echocardiography against percent diameter stenosis was 67%, against pressure gradient 88%. The specificity against these two parameters was 100% and 84%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是以定量冠状动脉造影为参照，评估自行车运动超声心动图的诊断价值。对70例连续接受冠状动脉造影的患者进行了运动超声心动图检查。在标准切面（胸骨旁长轴和短轴、心尖两腔和四腔切面）获取静息、峰值及运动后即刻的数字图像环。基于16节段模型进行室壁运动分析，对每个节段从3分（运动增强）到 -1分（运动减弱）进行评分。当至少一个节段的室壁运动从静息到峰值或运动后至少降低一个评分时，运动超声心动图被认为是阳性。使用自动定量冠状动脉造影软件评估电影造影图像。基于最大狭窄血流储备时的血流假设计算跨狭窄压力阶差。压力损失>30 mmHg且定量测量的直径狭窄百分比>50%被认为具有临床意义。对40 - 69%这一可疑范围内的狭窄进行单独分析。在冠状动脉疾病的诊断中，运动超声心动图优于运动诱发的ST段压低。在70例患者的总体样本中，运动超声心动图对直径狭窄百分比的敏感性为84%，对压力阶差的敏感性为86%。对这两个参数的特异性分别为86%和84%。在分析40 - 69%狭窄的亚组（N = 14）时，运动超声心动图对直径狭窄百分比的敏感性为67%，对压力阶差的敏感性为88%。对这两个参数的特异性分别为100%和84%。（摘要截选至250字）
