AN ANALYSIS OF FACTORS INFLUENCE ELECTROCARDIOGRAM STRESS TESTING FOR DETECTING CORONARY HEART DISEASEAN ANALYSIS OF FACTORS INFLUENCE ELECTROCARDIOGRAM STRESS TESTING FOR DETECTING CORONARY HEART DISEASE
摘要(Abstract)：
<正> Although exercise-induced ST segment depression is thought to be a reliabièmarker of myocerdinl ischemia in most patients,the diagnostic accuracy ofST segment response was influenced by many factors.Objective:Factors influence electrocardiogram(ECG)stress testing were evaluated inthis study.Methods:The treadmill stress test and coronary angiogramrecords were reviewed retrospactively in 453 consecutive patients from1991-1997.There were 44 cases with normal coronary angiogram butpositive exercise stress test results(false-positive,group A),and 33 cases withboth negative angiogram and exercise test(true-negntive,group B).Wecompared the effects of baseline ECG、echocardiogram、abnormalsystolic blood pressure and diabetes mellitus in the two groups.Results:1.There were no difference in age and gender between group A(42men and2 women,age 49±11 years)end B(27 men end 5 women,age 48±10 years).2.There were no significant differences in the two group by baseline ECG inbundle branch block(7 Vs 1)and ST segment depression(9 Vs 4).3.Patientswith left ventricular(LV)hypertrophy by ECG(11 Vs 1,p<0.05)or byechocardiogram(16 Vs 4,p<0.05)were more easy to have false-positivestress test results.4.Abnormal postexercise systolic blood pressure responsedid not influence exercise test results(7vs 1,p>0.05).5.Patients with diabetesmellitus had higher incidence of false-positive stress test results(7 Vs0,p<0.05).Conclusion:Our results suggest that consideration of LVhypertrophy and diabetes mellitus,in combinations with ST depression,mayimprove the accuracy of ECG stress tasting for detecting CHD.
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