Improved Efficiency of Treadmill Exercise Testing Using a Multiple Lead ECG System and Basic Hemodynamic Exercise Response
Improved Efficiency of Treadmill Exercise Testing Using a Multiple Lead ECG System and Basic Hemodynamic Exercise Response
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使用多导联心电图系统和基本血流动力学运动反应提高跑步机运动测试的效率
DOI：
10.1161/01.cir.57.1.71
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发表时间：
1978
期刊：
影响因子：
37.8
通讯作者：
R. Ferguson
中科院分区：
文献类型：
--
作者：
B. Chaitman;M. Bourassa;P. Wagniart;F. Corbara;R. Ferguson
连续100名静息心电图正常的男性在运动期间和运动后进行了14导联的最大跑步机试验。第二天进行的冠状动脉造影显示66例患者冠状动脉狭窄k70%。将从V6电极导线获得的测试结果与不同的电极导线组合进行比较，并与动脉造影结果相关。在37名使用单独V 1导联的男性中，与使用11导联的50名男性（P < 0.05）、使用CM 6、CC 5、Cl（下）导联系统的52名男性（P < 0.05）和使用所有14导联的58名男性（P < 0.001）相比，出现了阳性运动试验。阳性试验的预测值在89-95%之间变化，并且通过添加多个导联没有显著改变。45例多支病变患者中43例（96%）14导联心电图阳性。使用14导联有助于预测多支血管疾病的参数为：1）缺血首次出现的时间; 2）缺血首次出现时的压力率乘积; 3）可达到的最大工作负荷。一般来说，ST段压低的幅度和运动后ECG阳性恢复正常所需的时间不是多支血管疾病的有用预测因子。我们的结论是，使用多个导线提高了灵敏度和效率的最大平板运动试验。如果将多个导联与运动期间收集的生理数据相结合，则可以进一步提高运动测试结果的有用性。
One hundred consecutive men with a normal ECG at rest had a maximal treadmill test using 14 leads during and postexercise. Coronary arteriography performed the following day revealed coronary stenoses k70% in 66 patients. Test results obtained from a V6 lead were compared to different lead combinations and were correlated with arteriographic findings. A positive exercise test occurred in 37 men using an isolated V, lead compared to 50 men (P < 0.05) using 11 leads, 52 men (P < 0.05) using a combined CM6, CC5, Cl (inferior) lead system and 58 (P < 0.001) men using all 14 leads. The predictive value of a positive test varied between 89-95% and was not changed significantly by the addition of multiple leads. The 14 lead ECG was positive in 43/45 (96%) patients with multivessel disease. Parameters which helped to predict multivessel disease using 14 leads were 1) the time that ischemia first appeared 2) the pressurerate product at the time ischemia first appeared, and 3) the maximum workload that could be attained. In general, the magnitude of STsegment depression and the time required for a positive ECG to return to normal postexercise were not useful predictors of multivessel disease. We conclude that the use of multiple leads improves the sensitivity and efficiency of the maximal treadmill exercise test. The usefulness of exercise test results can be further improved if multiple leads are combined with physiologic data collected during exercise.