摘要
Toinvestigatetherelationshipbetweenthechronotropicincompetenceandangiographicseverityofcoronaryarterydisease,andtheclinicalvalueofinappropriatechronotropicresponsesinexercise.MethodsCoronaryangiographywasperformedin130patientssuspectedordiagnosedascoronaryheartdisease(CHD),andangiographicseverityofcoronaryarterydiseasewasquantitatedbyDukescoreandGensiniscore.Thepatientsweredividedinto4groups:non-CHDgroup(39cases),CHDgroupwithonlyonecoronaryarteryinvolved(CHD1,30cases),CHDgroupwithtwocoronaryarteriesinvolved(CHD2,31cases)andCHDgroupwiththreecoronaryarteriesinvolved(CHD3group,30cases).Amonthbeforecoronaryangiography,symptom-limitedbicycleergometorexercisehadbeenaccomplished,thechronotropicresponsehadbeenmeasuredandexpressedasratioofheartratereserve(HRR)andthemaximalage-predictedheartrateachieved(rHR).ResultsAnalysisofvarianceshowedthatrHRandHRRweremuchsignificantlylower(allP<0.01)inCHD2group(rHR0.793±0.078,HRR0.626±0.110)andCHD3group(rHR0.775±0.065,HRR0.586±0.125)thanthatinnon-CHDgroup(rHR0.888±0.062,HRR0.798±0.105)andCHD1group(rHR0.857±0.084,HRR0.735±0.146).rHRwassimilarbothbetweennon-CHDgroupandCHD1group(P>0.05)andbetweenCHD2groupandCHD3group(P>0.05).HRRhasnodifferencebetweenCHD2groupandCHD3group(P>0.05),butwassignificantlydifferentbetweennon-CHDgroupandCHD1group(P<0.05).TherewasasignificantlynegativecorrelationbetweenrHR,HRRandDukescore(r=-0.554,-0.578,respectively,allP<0.01),Gensiniscore(r=-0.453,-0.467,respectively,allP<0.01).CHDproportionreached75%inpatientswhohadpositiverHR(orHRR)andnon-STdepression.Diagnosticvalue[sensitivity0.868(P<0.01),0.846(P<0.01),specificity0.462,0.462,accuracy0.746(P<0.05),0.731,positivepredictivevalue0.790,0.786,negativepredictivevalue0.600,0.563,respectively]ofrHR<85%orHRR<72%whichwereusedasan
出版日期
2008年03月13日（中国期刊网平台首次上网日期，不代表论文的发表时间）
