objective To study how to improve the accuracy of treadmill exercise testing(TET).Methods TET was performed before coronary angiography (CAG) for 147 subjects admitted into our departmentbecause of suspicion of angina...objective To study how to improve the accuracy of treadmill exercise testing(TET).Methods TET was performed before coronary angiography (CAG) for 147 subjects admitted into our departmentbecause of suspicion of angina or coronary artery disease (CAD), then: (1) Every subject was inquired about hissymptoms and physically examined in detail before the testing. Chest pain was divided into ischemic (ICP) ornon - ischemic (NICP) pattern. (2) Informations got from TET, like angina, ST segment depression, and SPB ratio,were analyzed in detail. Results (1) When the patients showed chest pain of ICP pattern and positive TETresults, the sensitivity of TET would be 95%, for patients with NICP chest pain, the negative result of TET meansthat their coronary arteries is normal with the accurate possibility of 98%. (2) By our new criteria of TET, thesensitivity and specificity of TET were 89% and 95% respectively, both higher than those in theliterature. Conclusion in this report, we found TET was more sensitive and accurate if we knew the symptomsprior, especially in detail the characteristics of chest pain, and consider different parameters in combination.展开更多
Objective:The clinical value of QRS prolngation as a indicator of risk ofischemic ventricular arthythmia induced by exercise in the patient withischemic heart disease.Methods:17 case patients with ventricular arthythm...Objective:The clinical value of QRS prolngation as a indicator of risk ofischemic ventricular arthythmia induced by exercise in the patient withischemic heart disease.Methods:17 case patients with ventricular arthythmias were studiedbefore and after myocardial revascularization.These results werecompared with 19 control patients with no ventricular arrhythmia.Theresting and peak exercise electrocardiogram were examined with respectto QRS duration,ST-segment depression,and JT intervals.Result:The QRS duration at rest was similar in case and control patientsand increased significantly with exercise in both groups.However,theQRS prolongation was larger in the case group.In both groups,the QRSprolongation was associated with significant ST-segment depression.TheQRS prolongation】15msec predicted ischimia-related ventriculararrhythmia in 73% of the patients.After myocardial revascularization,there were no QRS prolongation with exercise in either group.Conclusion:QRS prolongation】14msec may be a useful indicator of riskof ischemic ventricular arrhythmia related to exercise in the patients withtschemie heart disease.展开更多
The aim of this present study was to investigate the effects of training on exercise tolerance of patients with coronary heart disease after percutaneous coronary intervention.Fifty-seven cases of coronary heart disea...The aim of this present study was to investigate the effects of training on exercise tolerance of patients with coronary heart disease after percutaneous coronary intervention.Fifty-seven cases of coronary heart disease after percutaneous coronary intervention were divided randomly into the rehabilitation training group(26 cases) and control group(31 cases).Patients in the rehabilitation training group received rehabilitation training at different stages and exercise intensities 3 d after percutaneous coronary intervention for 3 months.The heart rate,blood pressure,ECG changes in treadmill exercise test,and the frequency of anginal episodes were observed.The results showed that NST and ΣST of ECG and the frequency of anginal episodes were significantly reduced in the rehabilitation training group.In addition,exercise tolerance was improved and the total exercise time was lengthened in these patients.Moreover,ST segment depression time and emergence time of angina with exercise were also lengthened compared with controls(P 〈 0.05,or 0.01).However,the heart rate and blood pressure before and after exercise of the two groups were similar.The study indicated that rehabilitation training could significantly relieve angina,amend ischemic features of ECG,and improve exercise tolerance of coronary heart disease patients after percutaneous coronary intervention.展开更多
Background Clinical meaning of recovery phase limited ST segment depression of a treadmill exercise test is controversial.The aim of this study was to re-assess the diagnostic and prognostic value of ST segment depres...Background Clinical meaning of recovery phase limited ST segment depression of a treadmill exercise test is controversial.The aim of this study was to re-assess the diagnostic and prognostic value of ST segment depression during the recovery phase with the active phase of a treadmill exercise test in suspected coronary artery disease patients.Methods Clinical,exercise and angiographic data were retrospectively collected from 602 patients in the study.Five hundred and seventy-six patients developed ST segment depression during the active phase of the treadmill exercise test (group 1) and 26 patients developed ST segment depression only during the recovery phase (group 2).Results With similar major clinical features,the prevalence of significant coronary artery stenosis and average Gensini scores were lower in the recovery phase-limited depression patients (group 2 vs.group 1,50.0% vs.66.9%,P=0.031 and group 2 vs.group 1,1.5 vs.8.5,P=0.04).At a median follow up of 50.9 months for 22 group 2 and 34.8 months for 438 group 1 patients,the prevalence of total cardiac events was higher in group 1 than in group 2 patients (RR 1.60,95% Cl 1.00-2.54,P=0.049).Conclusion The present study provides preliminary evidence that the diagnostic and prognostic value of recovery phaselimited ST segment depression of treadmill exercise test is limited.展开更多
目的探究平板运动试验(TET)与静息心电图(ECG)联合评估对冠心病的诊断价值。方法选取2020年1月至2023年1月烟台市烟台山医院纳入的100例疑似冠心病患者作为研究对象,年龄32~75(52.43±2.18)岁,体质量指数(23.55±1.87)kg/m2。...目的探究平板运动试验(TET)与静息心电图(ECG)联合评估对冠心病的诊断价值。方法选取2020年1月至2023年1月烟台市烟台山医院纳入的100例疑似冠心病患者作为研究对象,年龄32~75(52.43±2.18)岁,体质量指数(23.55±1.87)kg/m2。以冠状动脉造影(CAG)诊断结果作为“金标准”,对所有患者实施静息ECG检查和TET,比较分析静息ECG、TET及静息ECG联合TET在冠心病中的诊断效能。采用χ_(2)检验。结果静息ECG检查表明,65例阳性、35例阴性、6例误诊;TET检查表明,72例阳性、28例阴性、4例误诊;TET检查比静息ECG检查更准确,更靠近CAG诊断结果。静息ECG联合TET检查结果表明,76例阳性、24例阴性、2例误诊;静息ECG联合TET检查比TET、静息ECG单项检查更准确,与CAG诊断结果一致性较好。静息ECG联合TET检查的曲线下面积(area under the curve,AUC)为0.913,灵敏度为92.50%,特异度为90.00%,均高于静息ECG、TET单独诊断结果。结论TET与静息ECG联合对评估冠心病有着良好的诊断价值。展开更多
文摘objective To study how to improve the accuracy of treadmill exercise testing(TET).Methods TET was performed before coronary angiography (CAG) for 147 subjects admitted into our departmentbecause of suspicion of angina or coronary artery disease (CAD), then: (1) Every subject was inquired about hissymptoms and physically examined in detail before the testing. Chest pain was divided into ischemic (ICP) ornon - ischemic (NICP) pattern. (2) Informations got from TET, like angina, ST segment depression, and SPB ratio,were analyzed in detail. Results (1) When the patients showed chest pain of ICP pattern and positive TETresults, the sensitivity of TET would be 95%, for patients with NICP chest pain, the negative result of TET meansthat their coronary arteries is normal with the accurate possibility of 98%. (2) By our new criteria of TET, thesensitivity and specificity of TET were 89% and 95% respectively, both higher than those in theliterature. Conclusion in this report, we found TET was more sensitive and accurate if we knew the symptomsprior, especially in detail the characteristics of chest pain, and consider different parameters in combination.
文摘Objective:The clinical value of QRS prolngation as a indicator of risk ofischemic ventricular arthythmia induced by exercise in the patient withischemic heart disease.Methods:17 case patients with ventricular arthythmias were studiedbefore and after myocardial revascularization.These results werecompared with 19 control patients with no ventricular arrhythmia.Theresting and peak exercise electrocardiogram were examined with respectto QRS duration,ST-segment depression,and JT intervals.Result:The QRS duration at rest was similar in case and control patientsand increased significantly with exercise in both groups.However,theQRS prolongation was larger in the case group.In both groups,the QRSprolongation was associated with significant ST-segment depression.TheQRS prolongation】15msec predicted ischimia-related ventriculararrhythmia in 73% of the patients.After myocardial revascularization,there were no QRS prolongation with exercise in either group.Conclusion:QRS prolongation】14msec may be a useful indicator of riskof ischemic ventricular arrhythmia related to exercise in the patients withtschemie heart disease.
文摘The aim of this present study was to investigate the effects of training on exercise tolerance of patients with coronary heart disease after percutaneous coronary intervention.Fifty-seven cases of coronary heart disease after percutaneous coronary intervention were divided randomly into the rehabilitation training group(26 cases) and control group(31 cases).Patients in the rehabilitation training group received rehabilitation training at different stages and exercise intensities 3 d after percutaneous coronary intervention for 3 months.The heart rate,blood pressure,ECG changes in treadmill exercise test,and the frequency of anginal episodes were observed.The results showed that NST and ΣST of ECG and the frequency of anginal episodes were significantly reduced in the rehabilitation training group.In addition,exercise tolerance was improved and the total exercise time was lengthened in these patients.Moreover,ST segment depression time and emergence time of angina with exercise were also lengthened compared with controls(P 〈 0.05,or 0.01).However,the heart rate and blood pressure before and after exercise of the two groups were similar.The study indicated that rehabilitation training could significantly relieve angina,amend ischemic features of ECG,and improve exercise tolerance of coronary heart disease patients after percutaneous coronary intervention.
文摘Background Clinical meaning of recovery phase limited ST segment depression of a treadmill exercise test is controversial.The aim of this study was to re-assess the diagnostic and prognostic value of ST segment depression during the recovery phase with the active phase of a treadmill exercise test in suspected coronary artery disease patients.Methods Clinical,exercise and angiographic data were retrospectively collected from 602 patients in the study.Five hundred and seventy-six patients developed ST segment depression during the active phase of the treadmill exercise test (group 1) and 26 patients developed ST segment depression only during the recovery phase (group 2).Results With similar major clinical features,the prevalence of significant coronary artery stenosis and average Gensini scores were lower in the recovery phase-limited depression patients (group 2 vs.group 1,50.0% vs.66.9%,P=0.031 and group 2 vs.group 1,1.5 vs.8.5,P=0.04).At a median follow up of 50.9 months for 22 group 2 and 34.8 months for 438 group 1 patients,the prevalence of total cardiac events was higher in group 1 than in group 2 patients (RR 1.60,95% Cl 1.00-2.54,P=0.049).Conclusion The present study provides preliminary evidence that the diagnostic and prognostic value of recovery phaselimited ST segment depression of treadmill exercise test is limited.
文摘目的探究平板运动试验(TET)与静息心电图(ECG)联合评估对冠心病的诊断价值。方法选取2020年1月至2023年1月烟台市烟台山医院纳入的100例疑似冠心病患者作为研究对象,年龄32~75(52.43±2.18)岁,体质量指数(23.55±1.87)kg/m2。以冠状动脉造影(CAG)诊断结果作为“金标准”,对所有患者实施静息ECG检查和TET,比较分析静息ECG、TET及静息ECG联合TET在冠心病中的诊断效能。采用χ_(2)检验。结果静息ECG检查表明,65例阳性、35例阴性、6例误诊;TET检查表明,72例阳性、28例阴性、4例误诊;TET检查比静息ECG检查更准确,更靠近CAG诊断结果。静息ECG联合TET检查结果表明,76例阳性、24例阴性、2例误诊;静息ECG联合TET检查比TET、静息ECG单项检查更准确,与CAG诊断结果一致性较好。静息ECG联合TET检查的曲线下面积(area under the curve,AUC)为0.913,灵敏度为92.50%,特异度为90.00%,均高于静息ECG、TET单独诊断结果。结论TET与静息ECG联合对评估冠心病有着良好的诊断价值。