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Objective To systematically evaluate the diagnostic value of treadmill exercise test (TET) compared with dynamic electrocardiography (DCG). Methods Databases including Cochrane library, MEDLINE,EMbase,Google Scholar and CNKI were retrieved to collect randomized clinical trials (RCT) and controlled clinical trials(CCT)focusing on comparison of TET and DCG. After screening according to the inclusion and exclusion criteria,all articles received Jadad quality assessment,and were analyzed using Review Manager Version 5.3 software(The Cochrane Collaboration,Oxford,United Kingdom). Results 9 papers with a total of 667 patients who underwent coronary angiography(CAG),TET and DCG were eventually enrolled. Results of the present Meta?analysis were as below.(1)Sensitivity:9 trials(n = 552)suggested that the sensitivity is 80.62% in TET Group versus 72.64%in DCG Group[RR=1.11,95%CI(1.04~1.18),P=0.002]. The difference was statistically significant.(2)Specificity:7 trails(n=126)indicated that no statistical significance[RR=0.86,95%CI(0.71~1.04),P=0.11]was found in specificity when comparing TET(68/115)and DCG(87/126). Conclusion TET has higher sensitivity but similar specificity in comparison with DCG,and it turns out to be a simple and feasible inspecting method in diagnosing coronary heart disease.
ABSTRACT
Objective:To investigate the clinical accuracy of cardiac remote monitoring, echocardiography (ECHO) and dynamic electrocardiography (DCG) in the diagnosis for silent myocardial ischemia (SMI) of coronary heart disease (CHD).Methods:63 patients with CHD were enrolled in this retrospective analysis and coronary angiography (CGA) was used as gold standard to analyze and judge the sensitivity, accuracy, specificity, positive predictive value, negative predictive value, Youden index and Kappa value of cardiac remote monitoring technique, ECHO and DCG in the diagnosis for SMI.Results: As the results of gold standard (CGA), 41 cases of 63 patients with CHD were diagnosed as SMI, the diagnose accordance rates of cardiac remote monitoring technique, ECHO and DCG, respectively, were 92.68%, 53.66% and 90.24%. And the sensitivity and specificity of the three methods for SMI, respectively, were 92.68% and 77.27%, 53.66% and 90.24%, and 86.36% and 22.73%. The Youden Indexes of the three methods were 0.700, 0.236 and 0.766, respectively. As above results, the Youden Indexes of cardiac remote monitoring technique and DCG were obviously higher than that of ECHO, and their diagnosis for SMI has excellent accordance with CGA. Conclusion:The technique of cardiac remote monitoring can be used as an effective supplementary means of DCG, and it has great clinical significance in the early diagnosis for SMI.
ABSTRACT
Objective:To investigate the clinical accuracy of cardiac remote monitoring, echocardiography (ECHO) and dynamic electrocardiography (DCG) in the diagnosis for silent myocardial ischemia (SMI) of coronary heart disease (CHD).Methods:63 patients with CHD were enrolled in this retrospective analysis and coronary angiography (CGA) was used as gold standard to analyze and judge the sensitivity, accuracy, specificity, positive predictive value, negative predictive value, Youden index and Kappa value of cardiac remote monitoring technique, ECHO and DCG in the diagnosis for SMI.Results: As the results of gold standard (CGA), 41 cases of 63 patients with CHD were diagnosed as SMI, the diagnose accordance rates of cardiac remote monitoring technique, ECHO and DCG, respectively, were 92.68%, 53.66% and 90.24%. And the sensitivity and specificity of the three methods for SMI, respectively, were 92.68% and 77.27%, 53.66% and 90.24%, and 86.36% and 22.73%. The Youden Indexes of the three methods were 0.700, 0.236 and 0.766, respectively. As above results, the Youden Indexes of cardiac remote monitoring technique and DCG were obviously higher than that of ECHO, and their diagnosis for SMI has excellent accordance with CGA. Conclusion:The technique of cardiac remote monitoring can be used as an effective supplementary means of DCG, and it has great clinical significance in the early diagnosis for SMI.