https://scholars.lib.ntu.edu.tw/handle/123456789/523200
標題: | Enhanced diagnosis of coronary artery disease in women by dobutamine thallium-201 ST-segment/heart rate slope and thallium-201 myocardial SPECT | 作者: | Yeih D.-F. Huang P.-J. YI-LWUN HO |
關鍵字: | Coronary artery disease; Dobutamine; Electrocardiograph; Thallium scan; Woman | 公開日期: | 2007 | 出版社: | Scientific Communications International Ltd | 卷: | 106 | 期: | 10 | 起(迄)頁: | 832-839 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background/Purpose: The diagnosis of coronary artery disease (CAD) in women presents a great challenge because of poor exercise capacity and inadequate heart rate response during stress test. The clinical significance of stress-related ST-segment/heart rate slope (ST/HR slope) value for evaluating CAD in women remains controversial. Therefore, we conducted the present study to assess the diagnostic performance of dobutamine ST/HR slope in women, compared with myocardial perfusion study using thallium-201 single-photon emission computed tomography (Tl-201 SPECT). Methods: A total of 51 female patients with suspected CAD underwent simultaneous 12-lead electrocardiographic recording during 3-minute stages of dobutamine infusion as well as Tl-201 SPECF, and coronary angiography was performed within 2 weeks post Tl-201 SPECT. The sensitivity, specificity, positive predictive value and negative predictive value of dobutamine ST/HR slope and Tl-201 SPECT were assessed, and the results of coronary angiography were used as a gold standard. Results: The sensitivity, specificity and accuracy of dobutamine ST/HR slope in detecting CAD were 43%, 83% and 61%, and those of Tl-201 SPEGF were 71%, 87% and 78%, respectively. However, using both positive results of Tl-201 SPECT and ST/HR slope for detecting CAD, the diagnostic specificity increased from 87% to 96%. Using both negative results of Tl-201 SPECT and ST/HR slope to exdude CAD, the negative predictive value increased from 71% to 85%. The accuracy of dobutamine ST/HR slope in detecting CAD was not affected by the use of beta-blockers. Conclusion: Dobutamine ST/HR slope is less sensitive and less accurate than Tl-201 SPECT for detecting CAD in women. However, it adds diagnostic benefit to Tl-201 SPECT with only a little extra calculation. ?2007 Elsevier & Formosan Medical Association. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-36148958276&doi=10.1016%2fS0929-6646%2808%2960048-0&partnerID=40&md5=00a3034e971d1092b9c2c23308c0cce1 https://scholars.lib.ntu.edu.tw/handle/123456789/523200 |
ISSN: | 0929-6646 | DOI: | 10.1016/S0929-6646(08)60048-0 | SDG/關鍵字: | beta adrenergic receptor blocking agent; dobutamine; thallium 201; adult; aged; angiocardiography; article; controlled study; coronary artery disease; diagnostic accuracy; diagnostic value; drug induced headache; drug withdrawal; electrocardiography; female; heart muscle perfusion; heart palpitation; heart rate; heart ventricle extrasystole; heart ventricle tachycardia; human; hypertension; hypotension; major clinical study; prediction; sensitivity and specificity; side effect; single photon emission computer tomography; ST segment; supraventricular premature beat; thorax pain; yawning |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。