Desmet W, De Scheerder I, Piessens J
Department of Cardiology, University Hospital Gasthuisberg, Leuven, Belgium.
Am Heart J. 1995 Mar;129(3):452-9. doi: 10.1016/0002-8703(95)90267-8.
We studied the diagnostic value of exercise electrocardiographic (ECG) testing in 191 patients who were completely asymptomatic 6 months after a successful percutaneous transluminal coronary angioplasty procedure. With > 70%- and > 50%-diameter stenosis at follow-up as restenosis criteria, the sensitivities of exercise ECG testing were 29% and 21%; the specificities 89% and 91%; the positive predictive values 20% and 52%; the negative predictive values 93% and 70%; the accuracies 83% and 68%; and the risk ratios 2.8 and 1.7, for prevalences of 9% and 33%, respectively. There were no significant differences in the diagnostic value of exercise ECG testing between men and women, patients receiving or not receiving beta-blocking agents, and the presence or absence of pathologic Q waves. Significant differences in systolic blood pressure and the rate-pressure product at peak exercise were found between patients with and without restenosis. For individual patients, however, no practical conclusions can be drawn from these values. In conclusion, the diagnostic value of exercise ECG testing for silent restenosis is low, and supplementation with other techniques seems to be warranted.
我们对191例在成功接受经皮腔内冠状动脉成形术后6个月完全无症状的患者进行了运动心电图（ECG）测试的诊断价值研究。以随访时直径狭窄>70%和>50%作为再狭窄标准，运动ECG测试的敏感性分别为29%和21%；特异性分别为89%和91%；阳性预测值分别为20%和52%；阴性预测值分别为93%和70%；准确率分别为83%和68%；风险比分别为2.8和1.7，患病率分别为9%和33%。运动ECG测试的诊断价值在男性和女性、接受或未接受β受体阻滞剂治疗的患者以及有无病理性Q波之间无显著差异。有再狭窄和无再狭窄的患者在运动高峰时的收缩压和心率-血压乘积存在显著差异。然而，对于个体患者，从这些值中无法得出实际结论。总之，运动ECG测试对无症状再狭窄的诊断价值较低，似乎有必要辅以其他技术。
