ABSTRACT
BACKGROUND: The treadmill exercise test (TET) is one of the most common noninvasive diagnosis approaches for ischemic heart diseases, but potential reduction of TET accuracy among Chinese female patients was ignored by most studies, especially in perimenopause women. Hence, we aim to perform a systematic review and meta-analysis evaluating the TET diagnostic accuracy for Chinese women compared with coronary angiography (CAG). METHODS: PubMed, MEDLINE, EMBASE, CNKI and WANFANG (1990 to 2015) were performed to identify studies assessing the diagnostic accuracy of TET versus CAG. Random effects modeling strategies were used to produce summary receiver operating characteristic (SROC) curves, including overall estimates for sensitivity and specificity. RESULTS: A total of 19 studies involving 2396 Chinese females were included in our systematic review. TET has moderate levels of sensitivity (0.80) and specificity (0.65) to detect coronary artery stenoses in female patients with suspected coronary artery diseases, generating 0.79 of the area under the curve (AUC). In subgroup analyses, the pooled sensitivity of postmenopause and premenopausal/perimenopausal groups were 0.83 and 0.80, respectively. However, the postmenopause group has a higher pooled specificity: 0.68 versus 0.32 compared with premenopausal/perimenopausal women, and a higher corresponding AUC (0.81 versus 0.56). CONCLUSIONS: TET may be used as a triage test for women with suspected and subclinical CAD. The positive results of TET should be treated with caution because of its higher false-positive, especially for premenopausal/perimenopausal women, and further confirmatory diagnosis is needed. However, patients with negative TET results could be precluded for further evaluation using CAG, and avoid unnecessary risk and economic burden to patients.
Subject(s)
Asian People , Coronary Angiography/standards , Coronary Artery Disease/diagnosis , Exercise Test/standards , Coronary Angiography/methods , Coronary Artery Disease/physiopathology , Exercise Test/methods , Female , Humans , Perimenopause/physiology , Postmenopause/physiology , Reproducibility of ResultsABSTRACT
Objective To explore the effect of psychological nursing on the treadmill exercise tests(TET)in patients with cardiacneurosis.Methods 86 patients with cardiacneurosis were randomly divided into the treatment group(n=44)and the control group(n=42): both were treated with medication for two weeks and the former with extra treatment of psychological nursing intervention.Then the anxiety and depression among all the participants were assessed using the Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS).The two groups were compared in terms of anxiety and depression as well as TET.Results The scores on anxiety and depression in the treatment group were significantly lower than those in the control group and the negative rate of TET was significantly higher than that in the control group(all P<0.05).Conclusion The psychological nursing intervention may reduce the anxiety and depression of the patients with cardiacneurosis and improve the accuracy of TET.
ABSTRACT
Objective To investigate the diagnostic value of treadmill exercise tests (TET), Hoher electro-cardiogram in coronary artery disease(CAD) patients. Methods 144 patients who clinically diagnosed as CAD,un-derwent TET and Hoher electrocardiogram. Then the patients with the positive results were examined by coronary arte-riography(CAG). According to the results of CAG the diagnostic value of TET and Hoher electrocardiogram was per-formed with comparative analysis. Results The sensitivity, specificity and evaluated accuracy rates of TET were 93.3% ,72. 2% and 73. 8% respectively. But the sensitivity,specificity and positive evaluated accuracy rates of Hol-ter electrocardiogram to examine myocardial iachemia were 76.7%, 88.4%, 57.1%. Conclusions The combined examination of TET and Holter electrocardiogram could preliminarily estimate the stenosis site of coronary artery. For the patients with unconditional GAG, those two examinations could increase the diagnostic reliability of positive rate of myocardial isehemia, and on this basis to enhance the diagnostic level of the stenosis site of coronary artery.
