Abstract

Introduction

Exercise electrocardiography (EET) is a safe and cost-effective method to predict the presence, prognosis, and severity of coronary artery disease (CAD). Various score models have been developed to increase predictive power of EET. In this study, we aimed to evaluate whether adding ST depression duration could have an effect on increasing the value of Duke treadmill score (DTS) in predicting obstructive CAD.

Methods

In this single centred, cross-sectional study, we evaluated a total of 258 patients who presented with a complaint of chest pain and undergone coronary angiogram in result of a positive EET. DTS was calculated for all the patients. The new score-revised DTS- was calculated by adding total ST depression time to classical DS parameters. We compared area under the curve (AUC) of DTS and revised DTS by Delongi method.

Results

Mean age of the group was 58.43 ± 9.37, and 37.2% (n = 96) were female. Mean total ST-depression duration was 171.72 ± 91.43 msec in normal artery group,241.54 ± 118.11 msec in non-obstructive CAD group, and 281.26 ± 113.64 in obstructive CAD group.ST-depression duration in both exercise and recovery, and total ST depression duration were significantly higher in obstructive CAD group than non-obstructive and normal artery groups (p = 0.024, p = 0.01, p < 0.01, and p < 0.01, respectively). Revised DTS had significantly higher predictive value of obstructive CAD compared to classical DS (AUC (95%CI): 0.744 vs. 0.626, p < 0.001). The AUC of DS was significantly lower than the new score (z-score:3.274, p = 0.011).

Conclusion

In conclusion, adding ST depression duration to DTS calculation is increasing the discriminative value of DTS to predict obstructive CAD. Benefits of EET within the context of the management of CAD is well-known, hence, it is clear that physicians may use revised DTS.

中文翻译：

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将 ST 段压低持续时间添加到 Duke 跑步机评分中，以提高运动心电图预测阻塞性冠状动脉疾病的诊断准确性

摘要

介绍

运动心电图 (EET) 是预测冠状动脉疾病 (CAD) 的存在、预后和严重程度的一种安全且经济有效的方法。已经开发了各种评分模型来提高 EET 的预测能力。在本研究中，我们旨在评估增加 ST 压低持续时间是否会影响 Duke 跑步机评分 (DTS) 在预测阻塞性 CAD 中的价值。

方法

在这项单一中心的横断面研究中，我们评估了总共 258 名主诉胸痛并因 EET 阳性而接受冠状动脉造影的患者。计算所有患者的 DTS。新评分修正的 DTS- 是通过将总 ST 压低时间添加到经典 DS 参数来计算的。我们比较了 DTS 的曲线下面积 (AUC) 并通过 Delongi 方法修正了 DTS。

结果

该组的平均年龄为 58.43 ± 9.37，37.2% ( n  = 96) 为女性。正常动脉组的平均总 ST 压低持续时间为 171.72 ± 91.43 毫秒，非阻塞性​​ CAD 组为 241.54 ± 118.11 毫秒，阻塞性 CAD 组为 281.26 ± 113.64。运动和恢复时的 ST 压低持续时间以及总 ST 压低阻塞性 CAD 组的持续时间显着高于非阻塞性和正常动脉组（分别为p  = 0.024、p  = 0.01、p  < 0.01 和p  < 0.01）。与经典 DS 相比，修订后的 DTS 对阻塞性 CAD 的预测价值显着更高（AUC (95%CI)：0.744 与 0.626，p < 0.001)。DS 的 AUC 明显低于新分数 (z-score:3.274, p  = 0.011)。

结论

总之，将 ST 压低持续时间添加到 DTS 计算中会增加 DTS 预测阻塞性 CAD 的判别值。EET 在 CAD 管理方面的好处是众所周知的，因此，很明显，医生可以使用修订后的 DTS。