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目的评价平板运动试验后心率恢复在PCI术后再狭窄诊断中的价值。方法成功行经皮冠状动脉介入治疗(PCI)的88例患者,术后6～9个月行平板运动试验及冠状动脉造影,以冠状动脉造影结果为参照,比较传统标准结合心率恢复异常与传统标准诊断再狭窄的敏感性、特异性、阳性预测值、阴性预测值。结果 88例患者中有22例经冠状动脉造影证实发生再狭窄。与传统标准相比,以运动后第一分钟心率恢复值(HRR1))异常诊断再狭窄的敏感性、特异性、阳性预测值和阴性预测值无明显差异(p>0.05)。在传统标准阳性的基础上结合HRR1异常诊断再狭窄的特异性(86.4%)较传统标准有显著提高(p<0.05)。结论运动后心率恢复异常可作为诊断再狭窄的无创方法之一,传统标准结合HRR1异常可提高平板运动试验对再狭窄的诊断价值。
Objective To evaluate the value of heart rate recovery after treadmill exercise test in the diagnosis of restenosis after PCI. Methods A total of 88 patients undergoing percutaneous coronary intervention (PCI) were enrolled in this study. Treadmill exercise test and coronary angiography were performed 6 to 9 months after surgery. Coronary angiography was used as a reference. The conventional standard was compared with the conventional standard Sensitivity, specificity, positive predictive value, negative predictive value for diagnosis of restenosis. Results Twenty-two of the 88 patients underwent coronary angiography to confirm restenosis. There was no significant difference in the sensitivity, specificity, positive predictive value and negative predictive value of HRR1 in the diagnosis of restenosis after the first minute of exercise compared with the traditional standard (p> 0.05). The specificity of diagnosis of restenosis combined with HRR1 (86.4%) was significantly higher than that of the traditional standard (p <0.05). Conclusion Abnormal heart rate recovery after exercise can be used as one of the noninvasive methods to diagnose restenosis. The combination of traditional criteria and abnormal HRR1 can improve the diagnostic value of treadmill exercise test in restenosis.