Hanrath P, Hoffmann R, Lankes W, Stellbrink C
Medizinische Klinik I, Rheinisch-Westfälischen Technischen Hochschule Aachen.
Z Kardiol. 1993;82 Suppl 5:121-6.
Stress-echocardiography represents a new non-invasive, alternative approach in the assessment of patients with coronary artery disease. By means of dynamic or pharmacological stress or by atrial pacing regional wall motion abnormalities can be induced, which can be identified by 2D-echocardiography. Beyond the indirect detection of ischemia this approach allows a better quantification of the amount of ischemia and of global LV function, which is advantageous compared to stress ECG recording or myocardial scintigraphy. Disadvantageous is however, the subjective reading of the echo itself. In experienced hands stress-echocardiography has proven to be as sensitive and specific as myocardial scintigraphy. Recently, in addition the diagnostic potential of myocardial cell injury has been improved by the detection of specific antibodies versus Troponin T. In comparison with conventional biochemical markers of myocardial cell necrosis Troponin T analysis has been proven to be superior in postoperative or traumatic cardiac damage or in the setting of acute myocardial infarction. In this situation the time window is improved by an earlier rise compared to CK and a longer detection rate compared to lactate dehydrogenase.
负荷超声心动图是评估冠心病患者的一种新的非侵入性替代方法。通过动态或药物负荷或心房起搏可诱发局部室壁运动异常，二维超声心动图可识别这些异常。除了间接检测缺血外，这种方法还能更好地量化缺血量和左心室整体功能，与负荷心电图记录或心肌闪烁显像相比具有优势。然而，超声心动图本身的主观解读是其劣势。在经验丰富的医生手中，负荷超声心动图已被证明与心肌闪烁显像一样敏感和特异。最近，通过检测针对肌钙蛋白T的特异性抗体，心肌细胞损伤的诊断潜力也得到了提高。与传统的心肌细胞坏死生化标志物相比，肌钙蛋白T分析在术后或创伤性心脏损伤或急性心肌梗死情况下已被证明更具优势。在这种情况下，与肌酸激酶相比，肌钙蛋白T升高更早，与乳酸脱氢酶相比，检测时间更长，从而改善了时间窗。
