Hecht H S, DeBord L, Shaw R, Chin H, Dunlap R, Ryan C, Myler R K
San Francisco Heart Institute, Seton Medical Center, Daly City, CA 94015.
J Am Soc Echocardiogr. 1993 Mar-Apr;6(2):177-85. doi: 10.1016/s0894-7317(14)80488-4.
To compare the accuracy of supine bicycle stress echocardiography (SBSE), a new technique for evaluating coronary disease during peak exercise, with tomographic thallium-201 exercise imaging (SPECT), 71 patients were evaluated by SBSE, SPECT, and coronary arteriography. Twenty patients had normal coronary vessels; 22 had single-vessel, 14 had double-vessel, and 15 had triple-vessel disease. There were no differences in sensitivity (90% vs 92%), specificity (80% vs 65%), and accuracy (87% vs 85%) between SBSE and SPECT for the group of 71 patients. The results were similar in patients with and without prior myocardial infarction and with single-, double-, or triple-vessel disease. There were no differences between SBSE and SPECT for disease detection for the group of 213 individual vessels in sensitivity (88% vs 80%), specificity (87% vs 84%), and accuracy (88% vs 82%), but SBSE was more sensitive for the left anterior descending artery (97% vs 82%, p < 0.005) and for arteries involved in triple-vessel disease (93% vs 69%, p < 0.01) and more specific for the right coronary artery (88% vs 66%, p < 0.01). Supine bicycle exercise was associated with significantly lower maximal heart rates than treadmill exercise but with significantly higher systolic and diastolic blood pressures. There were no differences in heart rate x systolic blood pressure. We conclude that SBSE and SPECT are equally reliable for coronary disease detection in patients and for evaluation of disease in specific arteries with the exception of SBSE's higher sensitivity for the left anterior descending artery and arteries involved in triple-vessel disease and higher specificity for the right coronary artery.
为比较仰卧位踏车负荷超声心动图（SBSE）这一用于评估运动高峰时冠状动脉疾病的新技术与断层心肌灌注显像（SPECT）的准确性，对71例患者进行了SBSE、SPECT及冠状动脉造影检查。20例患者冠状动脉血管正常；22例为单支血管病变，14例为双支血管病变，15例为三支血管病变。在这71例患者中，SBSE与SPECT在敏感性（90%对92%）、特异性（80%对65%）和准确性（87%对85%）方面无差异。有或无既往心肌梗死以及单支、双支或三支血管病变的患者结果相似。在213支个体血管的疾病检测中，SBSE与SPECT在敏感性（88%对80%）、特异性（87%对84%）和准确性（88%对82%）方面无差异，但SBSE对左前降支动脉（97%对82%，p<0.005）和三支血管病变累及的动脉（93%对69%，p<0.01）更敏感，对右冠状动脉更具特异性（88%对66%，p<0.01）。仰卧位踏车运动时的最大心率显著低于平板运动，但收缩压和舒张压显著更高。心率×收缩压无差异。我们得出结论，除SBSE对左前降支动脉和三支血管病变累及的动脉具有更高敏感性以及对右冠状动脉具有更高特异性外，SBSE和SPECT在检测患者冠状动脉疾病及评估特定动脉疾病方面同样可靠。
