心率调整的ST段降低参数预测冠心病病变程度相关研究

Heart Rate Adjustment of ST Segment Depression for Identifying and Quantifying Coronary Arteriosclerosis Disease

目的:探讨心率调整的ST段降低方法识别冠心病3支血管病变的价值,并把ST/HR斜率和ST/HR指数两种指标和传统ST段指标进行了系统比较。方法:选取2001年1月～2002年3月行平板运动ECG试验并在随后3周内住院行冠状动脉造影的可疑冠心病患者共173例,应用Comell运动试验方案,分别测定并计算运动试验过程中ST段变化值及ST/HR斜率和ST/HR指数值,以冠状动脉造影结果作为诊断冠心病的标准。结果:传统ST段指标(ST段降低≥0.2mV)、ST/HR斜率和ST/HR指数定量识别冠心病3支血管病变的敏感性分别为30％、81％和64％,特异性分别为70％、65％和69％。ST/HR斜率和ST/HR指数识别冠心病3支血管病变的敏感性显著高于传统ST段指标(P<0.001),特异性无显著性差异(P<0.05)。结论:与传统ST段指标相比ST/HR斜率和ST/HR指数明显提高了运动ECG试验定量识别冠心病3支血管病变的敏感性。

Objective: To assess the eflect of heart rate adjustment of ST segment depression for identifying 3 - vessel coronary artery disease( CAD) and compare both ST/ HR slope and ST/ HR index with standard ST segment depression criteria. Methods: One hundred and seventy three patients with suspected coronary artery disease were referred for a routine treadmill exercise electrocardiogram, and subsequently underwent selective coronary angiography within 3 weeks. The magnitude of ST segment depression, ST/HR slope and ST/ HR index calculations are performed by a computerized EGG system, with exercise according to the Cornell protocol. CAD was defined by coronary angiography. Results: Standard electrocardiographic criteria ,ST/HR slope criteria and ST/HR index criteri-a identified 3-vessel CAD with a sensitivity of 30% ,81% and 64% respectively, with a specificity of 70% ,65% and 69% respectively . Sensitivity for 3 - vessel CAD of ST/HR slope and ST/HR index were all significantly greater than that of Standard electrocardiographic test criteria(P <0.001) ,with no significantly change in specificity (P > 0.05) .Conclusion: Sensitivity for identifying 3-vessel CAD of ST/HR slope and ST/HR index were significantly increased compared with Standard electrocardiographic test criteria, with no significantly change in specificity.