Heinbuch S, Koenig W, Gehring J
Hoehenried Cardiac Rehabilitation Center, Bernried, Germany.
J Electrocardiol. 1993 Apr;26(2):137-45. doi: 10.1016/0022-0736(93)90006-y.
The authors investigated 244 consecutive patients with suspected coronary artery disease by coronary angiography and quantitative left ventriculography to compare the Minnesota Q/QS code (MC) with clinical electrocardiographic (ECG) interpretation. Patients who were suspected to have wall motion abnormalities for reasons other than coronary artery disease for possible regional wall motion abnormalities were excluded. Out of 244 patients, 159 (65%) had wall motion abnormalities. The sensitivity for detecting wall motion abnormalities was 21% for MC 1.1 and 51% for MC 1.1-3, whereas clinical ECG interpretation showed a sensitivity of 73%. Specificity for MC 1.1 was 93% and for MC 1.1-3 it was 84%. Specificity of clinical ECG interpretation (84%) was comparable. Compared to the MC, clinical ECG interpretation showed a stronger association with left ventricular ejection fraction, number of segments with abnormal wall motion, and severity of wall motion abnormality. Anterior myocardial infarction presented more often with clinical ECG changes (71%) and with a Q/QS code (50%) than inferior myocardial infarction (61% and 41%, respectively). In summary, in contrast to clinical ECG criteria, the MC has high specificity at the expense of a low sensitivity.
作者通过冠状动脉造影和定量左心室造影对244例连续的疑似冠心病患者进行了研究，以比较明尼苏达Q/QS编码（MC）与临床心电图（ECG）解读的情况。因冠状动脉疾病以外的原因疑似存在室壁运动异常的患者被排除，可能存在局部室壁运动异常。在244例患者中，159例（65%）存在室壁运动异常。检测室壁运动异常时，MC 1.1的敏感性为21%，MC 1.1 - 3的敏感性为51%，而临床心电图解读的敏感性为73%。MC 1.1的特异性为93%，MC 1.1 - 3的特异性为84%。临床心电图解读的特异性（84%）与之相当。与MC相比，临床心电图解读与左心室射血分数、室壁运动异常节段数以及室壁运动异常严重程度的关联更强。前壁心肌梗死出现临床心电图改变（71%）和Q/QS编码（50%）的情况比下壁心肌梗死更常见（分别为61%和41%）。总之，与临床心电图标准相比，MC特异性高但敏感性低。
