Wilson R A, Bamrah V S, Lindsay J, Schwaiger M, Morganroth J
Cardiology Division, Oregon Health Sciences University, Portland 97201-3098.
Am J Cardiol. 1993 Mar 1;71(7):536-45. doi: 10.1016/0002-9149(93)90508-a.
A multicenter study was performed to compare the diagnostic accuracy of a new technique, seismocardiography, with that of electrocardiography for physiologically and anatomically significant ischemic coronary artery disease (CAD) during exercise stress testing. Five participating centers enrolled 129 patients who had simultaneous seismocardiograms and 12-lead electrocardiograms at the time of their exercise treadmill stress tests. Two different definitions of CAD were used: anatomic and physiologically significant disease. The presence of anatomically significant CAD (> or = 50% diameter stenosis) was documented by coronary angiography. Physiologically significant CAD was defined as present in the same 129 patients when coronary arteriography (> or = 50% diameter stenosis) and thallium-201 scintigraphy (defect on initial postexercise images) were both abnormal. Seismocardiography had a significantly better sensitivity for detecting anatomic CAD than did electrocardiography (73 vs 48%; p < 0.001), without loss of specificity (78 vs 80%; p = NS). Exercise seismocardiography added significant incremental diagnostic information beyond that provided by exercise electrocardiography. Seismocardiography was more sensitive (without less specificity) in women and in patients who did not achieve maximal predicted heart rate. In patients with physiologically significant CAD, the seismocardiogram was also significantly more sensitive (78%) than was the electrocardiogram (55%) (p < 0.02), without loss of specificity (84 vs 74%). Seismocardiography significantly improved sensitivity for the detection of anatomic and physiologic CAD. It is easy to perform and may be a clinically useful adjunct in exercise stress testing.
一项多中心研究开展，旨在比较一种新技术——心震图检查法与心电图检查法在运动负荷试验期间对具有生理和解剖学意义的缺血性冠状动脉疾病（CAD）的诊断准确性。五个参与中心招募了129例患者，这些患者在进行运动平板负荷试验时同时接受了心震图检查和12导联心电图检查。采用了两种不同的CAD定义：解剖学意义上的疾病和生理学意义上的疾病。解剖学意义上显著的CAD（直径狭窄≥50%）通过冠状动脉造影记录。生理学意义上显著的CAD定义为在这129例患者中，冠状动脉造影（直径狭窄≥50%）和铊-201闪烁扫描（运动后初始图像上有缺损）均异常。在心震图检查法检测解剖学意义上的CAD方面，其敏感性显著高于心电图检查法（分别为73%和48%；p<0.001），且特异性未降低（分别为78%和80%；p=无显著性差异）。运动心震图检查法除了提供运动心电图检查法所提供的信息之外，还增加了显著的额外诊断信息。心震图检查法在女性和未达到最大预测心率的患者中更敏感（且特异性不降低）。在具有生理学意义上显著CAD的患者中，心震图检查的敏感性（78%）也显著高于心电图检查（55%）（p<0.02），且特异性未降低（分别为84%和74%）。心震图检查法显著提高了对解剖学和生理学意义上CAD的检测敏感性。它操作简便，可能是运动负荷试验中一种具有临床实用价值的辅助检查方法。
