Diagnostic value of combined parameters derived from ambulatory electrocardiography for detecting coronary artery disease in non-active chest pain patients
Diagnostic value of combined parameters derived from ambulatory electrocardiography for detecting coronary artery disease in non-active chest pain patients
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DOI：
10.12669/pjms.306.5176
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发表时间：
2014-11-01
影响因子：
2.2
通讯作者：
Du, Feng-He
中科院分区：
文献类型：
--
作者：
Jiang, Yue;Tian, Jun-Ping;Du, Feng-He
背景和目的：动态心电图（AECG）检测ST段偏移对冠状动脉造影（CAG）诊断冠心病（CAD）的价值存在争议。近年来，许多评价CAD的参数都可以从AECG中提取出来。因此，我们的目的是探讨AECG的诊断价值，在筛选CAD转CAG时，几个参数相结合。所有患者均行CAG和AECG检查。根据CAG，管腔直径减小>= 50%被认为是CAD。AECG检测指标包括ST段偏移、呼吸暂停低通气指数（AHI）、QT间期离散度（QTd）和心率变异性（HRV）。结果：104例患者中，CAG诊断冠心病57例（54.8%）。ST段偏移筛查冠心病的敏感性为64.9%，特异性为89.4%，Kappa值为0.528。ST段偏移、AHI、QTd和HRV至少3项联合检测的敏感性为89.5%，特异性为87.2%，Kappa值为0.767。结论：AECG对冠心病的诊断有重要价值，尤其是ST段偏移、AHI、HRV和QTd联合检测更有价值。
Background and Objective: The diagnostic value of ST-segment deviation detected by ambulatory electrocardiography (AECG) is controversial in identifying coronary artery disease (CAD) referred for coronary angiography (CAG). Recently, many parameters which evaluate CAD can be derived from AECG. Therefore, we aimed to investigate the diagnostic value of AECG in screening CAD referred for CAG when several parameters were combined.Methods: We studied the 104 chest pain inpatients. All patients received the CAG and AECG. A lumen diameter reduction of >= 50% was considered CAD according to CAG. The parameters derived from AECG included ST-segment deviation, apnea hypopnea index (AHI), QT interval dispersion (QTd) and heart rate variability (HRV). The diagnostic value of AECG in screening CAD was evaluated.Results: Of the 104 patients, 57 (54.8%) had CAD according to CAG. The sensitivity of ST-segment deviation in screening CAD was 64.9%; the specificity was 89.4%; and the Kappa value was 0.528. The sensitivity of at least three combined parameters including ST-segment deviation, AHI, QTd and HRV was 89.5%; the specificity was 87.2%; and the Kappa value was 0.767.Conclusion: AECG is very useful in screening CAD referred for CAG, especially while several parameters including ST-segment deviation, AHI, HRV and QTd are combined.