Diagnostic value of treadmill exercise test combined with 24 h dynamic electrocardiogram in patients with coronarv heart disease / 中国综合临床

ObjectiveTo evaluate the value of 24 h dynamic electrocardiogram (DCG) and treadmill exercise testing(TET) in diagnosing coronary heart disease(CHD),and analyze relevant index between coronary arteriography(CAG) and treadmill exercise testing.MethodsOne hundred and forty-nine borderline cases of coronary heart disease were enrolled.Every patient was examined by DCG,TET,and CAG,compared the diagnostic value of TET combined with DCG and TET or DCG alone,and record the increased heart rate during the first minute( △ HRl min) of TET and systolic blood pressure(SBP) recovery.The patients were divided into a CHD group and a non-CHD group according to the results of coronary angiography.ResultsThe sensitivity rate was 78.57％ and specific rate was 70.77％ by means of TET.The sensitivity rate was 61.90％ and specific rate was 66.15％ by means of DCG.The sensitivity rate was 95.23％ ,specific rate was 55.38％,positive predictive value was 73.39％ and negative predictive value was 90.00％ by parallel way of DCG and TET,its sensitivity rate (95.23％) and negative predictive value (90.00％ ) were more than those of DCG or TET alone.The sensitivity rate was 52.38％,specific rate was 95.38％,positive predictive value was 93.62％ and negative predictive value was 60.78％ by serial way of DCG and TET,its specific rate (95.38％) and positive predictive value (93.62％ ) were more than those of DCG or TET alone.The number of men in the CHD group was higher than the number of women.Ratio of systolic blood pressure recovery(rSBPR) in the CHD group was significantly higher than that in the non-CHD group ( P ＜ 0.01 ).Conclusion It can obviously enhance the sensitivity rate and specific rate if combined TET with DCG.Patients with CHD have a delayed decline in SBP during recovery which can be one of the indexes to estimate the extent of myocardial ischemia and coronary artery lesion.

Value of the ratio of systolic blood pressure during treadmill test in the diagnosis of coronary heart disease / 中国实用内科杂志

Objective To discuss the value of systolic blood pressure during recovery rate using treadmill exercise test to diagnose coronary heart disease.Methods A total of 88 patients underwent treadmill test and coronary angiography within 2 weeks,and the relativity was analysed between the third minute systolic blood pressure(3SBP)during recovery rate and the results of coronary angiography.Results The sensitivity、specificity、accuracy and prognostication of the third minute systolic blood pressure were:55.6%、82.0%、73.9% and 57.7%.Conclusion The index of the third minute systolic blood pressure is much more significant than the traditional ST standard in the specificity、accuracy and prognostication of diagnosing coronary heart disease.