Evaluation Of The Value Of Treadmill Exercise Test In The Diagnosis Of Coronary Heart Disease

Objective : to evaluate the diagnostic value of treadmill exercise test(TET)in coronary heart disease(CHD)and to explore the influencing factors of TET diagnosis.Methods : a total of 148 patients who were hospitalized in the Department of Cardiology of the second affiliated Hospital of Shantou University Medical College from November 2019 to March 2021 were retrospectively analyzed.All patients underwent TET and coronary angiography(CAG).CAG was used as the gold standard for the diagnosis of CHD to evaluate the diagnostic efficiency of TET.The data were analyzed by SPSS22.0 software,and the detection rates of single-vessel disease and multi-vessel disease,moderate stenosis(50%-74%)and severe stenosis(≥ 75%),left anterior descending artery(LAD),left circumflex branch(LCX)and right coronary artery(RLA)were compared by TET test.The positive predictive values of TET among different diagnostic conditions and different leads with ST segment changes were compared,The accuracy of TET among different clinical symptoms was compared,and the differences of TET results between different genders were explored.Multivariate logistics regression was used to analyze the independent influencing factors of false positive and false negative TET.Results : a total of 148 patients were included in this study,including 41 cases of TET positive and 17 cases of TET negative,and 90 cases of non-CHD,of which 29 cases were positive for TET and 61 cases were negative for TET.The sensitivity of TET in diagnosing CHD was 70.69%,the specificity was 67.78%,the positive predictive value was 58.57%,the negative predictive value was 78.21%,and the predictive accuracy was 68.92%.The sensitivity of Tet in single vessel disease was 57.58%,which was significantly lower than that in multi-vessel disease(P < 0.05).The sensitivity of TET for severe stenosis was 81.25%,which was higher than that of moderate stenosis 57.69%(P < 0.05).There was no significant difference in the sensitivity of TET between different locations of diseased vessels(P > 0.05).The positive predictive value of angina pectoris with ST segment change(85.71%)was significantly higher than that of angina pectoris(28.57%).The positive predictive value of limb lead with chest lead ST segment change was 78.95%,which was significantly higher than that of limb lead ST segment change(P < 0.05).There was no significant difference in the accuracy of TET among different clinical symptoms(P > 0.05).There was no difference in TET diagnosis between different genders(P > 0.05).The probability of false negative result of TET diagnosis of single vessel disease was 9 times higher than that of multi-vessel disease.Conclusion : the sensitivity and specificity of TET in the diagnosis of CHD are moderate,and the sensitivity is easily affected by the number of lesion branches and the degree of stenosis of CA,but the location of CA lesion has little effect on it,and the positive predictive value of TET is not high enough,it is easy to be affected by diagnostic conditions and different leads of ST segment changes.The accuracy of TET is moderate,and there is no correlation between different clinical symptoms and accuracy.Gender has no effect on the diagnosis of TET.The number of lesion branches is an independent factor affecting the false negative results of TET.