| [Objective]To investigate the characteristics of patients who underwent Exercise Treadmill Test(ETT) in Fu Wai Hospital and to evaluate the value of ETT for diagnosis of Coronary Artery Disease(CAD) by means of[Methods]41574 consecutive subjects admitted to Fu way Hospital and underwent an ETT from 2003 to 2007 were analysed retrospectively.In order to evaluate the value of ETT for diagnosis of CAD,comparative analysis.was specially focused on those patients who were suspected for CAD and underwent both ETT and Coronary Angiography (CAG)[Result]41574 patients underwent ETT during the study period.Among them men were 23030(55.4%) and women were 18544(44.6%) with mean age of 49.77±10.76 years.The mean age of the women was higher than the men(p＜0.05).Patients with age of 40～60 years accounted for 65.08%.The total positive rate of exercise treadmill test was 4.48%,which increased with age and the positive rate in the men was also higher than in the female(5.86%vs.2.77%,p＜0.05).The patients with symptom and suspected CAD accounted for the largest part of the total population(88.55%).Death related with ETT was one(0.24/10000).The incidence of ST-elevation and ventricular tachycardia were 2.4/10000(n=10) and 1.4/10000(n=6) respectively.Two patients developed sinus arrest after the test.525 patients suspected for CAD underwent both ETT and CAG.The mean age of the patients was 53.09±9.27 years.Among them,men were 389(74.1%) and women were. 136(25.9%).The sensitivity and the specificity of ETT for diagnosis of CAD were 60.66%and was 81.14%respectively.Both of the sensitivity and specificity in the men was higher than in the women(p＜0.05).There was no significant difference in the sensitivity of ETT between one-vessel diseased group and two-vessel diseased group. But the three-vessel diseased group was higher than one or two-vessel diseased group (p＜0.05).The sensitivity of ETT in LM group was higher than in non-LM group,but there is no statistically difference(p＞0.05).The sensitivity of ETT for LAD,LCX and RCA were 47.3%,57.14%,36.36%respectively.The results suggested that the sensitivity of ETT for different vessel was similar in both of more than 50%or 75%luminal occlusion group.Sensitivity of ETT for diagnosis of CAD in patients with diabetes mellitus(DM)(n=67) and hypertension(n=236) were 77.78%and 61.27%respectively, and the specificity was 95.45%and 97.87%respectively.Logistic regression analysis demonstrated that the age,hypertension and smoking are impact factors of false positive, whereas gender,age,number of diseased vessels,vessel occlusion,branch involvement, coronary collateral vessels and hyperlipemia are independent impact factors of false negative ETT results.[Conclusion]ETT was a safe and frequently used as a noninvasive diagnostic test of CAD.It had moderate degree sensitivity which was affected by number and extent of stenos is vessels rather than the position of diseased vessel.The specificity of ETT is high.The diagnostic of ETT may be more valuable in men,DM or hypertension patients. Analysis of the result of ETT combining with multiple clinical factors will improve the accuracy of diagnosis of CAD... |
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