The Control Study Of Early Accurate Diagnosis In Coronary Artery Disease Using Treadmill Exercise Test,CT Angiography Combined With T Peak-T End Interval

part 1 The control study of treadmill exercise test combined with coronary CT angiography in the diagnosis of coronary heart disease[Objective]To study the diagnosis value of coronary heart disease using Treadmill exercise test(TET)combined with coronary CT angiography(CCTA).[Method]In coronary artery angiography(CAG)as the gold standard,TET and CCTA data of 136 patients were analyzed retrospectively,which were suspected coronary artery disease,and emphatically analyzed the diagnosis efficiency in TET,CCTA,TET combined with CCTA.[Results]In diagnosis of coronary heart disease using TET separately,the sensitivity,specificity,accuracy,positive predictive value,negative predictive value were 78.94%,58.33%,69.85%,70.58%,68.63%respectively,and those using CCTA separately were 86.84%,63.33%,76.47%,75.00%,79.16%.those using TET combined with CCTA were 90.69%,80.00%,86.76%,88.63%,83.33%.In Combined diagnostic,The specificity,accuracy,positive predictive value were significantly higher than that of single diagnosis(P = 0.046,0.003,0.011),and the diagnostic sensitivity and negative predictive value have no statistical difference(P=0.097,0.199).[Conclusion]The diagnostic specificity,accuracy,positive predictive value for coronary heart disease in TET combined with CCTA were significantly higher than that of TET or CCTA.It can evaluate coronary artery lesions with different mechanism,and complementary supplement,and it will improve the detection rate and diagnostic accuracy in coronary heart disease patients.Part 2 The Diagnostic value of Tpeak-Tend interval in Treadmill exercise test for coronary heart disease[Objective]To investigate the Tpeak-Tend interval(Tpe),heart rate correction Tpeak-Tend interval(Corrected Tpeak-Tend interval,Tpec),Tpe/QT diagnostic value in myocardial ischemia of coronary heart disease,which are measured before and after the Treadmill exercise test.[Methods]52 patients of the ischemia group were diagnosed with coronary heart disease by Treadmill exercise test positive and coronary artery angiography,according to the lesion blood vessel count is divided into three groups(single lesion group,the double branch lesion,multivessel lesions group),and the other 52 patients of control group without cardiovascular disease and the Treadmill exercise test negative,All parameters(Tpe,Tpec,Tpe/QT value)are recorded in ischemia group and control group,and time points including before exercise,exercise peak,2 minutes after exercise,four minutes after exercise,six minutes after exercise and to calculate the correlation analysis between Gensini score and Tpe before the exercise in ischemia group.[Results]Tpe,Tpec,Tpe/QT value in ischemia group are higher than the control group,which in both before and after exercise.It was have significant statistical significance(P = 0.000),and Tpe,the Tpec value increases along with the lesion count increases,there are significant statistically difference(P = 0.000).Tpe shortened in exercise peak and Tpec,Tpe/QT extended than before exercise.It is indicate that Tpec?Tpe/QT is more sensitive than Tpe in reflect myocardial bipolar discrete degree and myocardial ischemia(P = 0·000).the correlation coefficient between Gensini score and Tpe before exercise with ischemic group is 0.399,P =0.003,linear regression analysis showed that they are significant correlation(F =9.461,P = 9:461).[Conclusion]Tpe can be used as a new indicator for reaction of coronary artery disease and myocardial ischemia.Tpec,Tpe/QT are more sensitive than Tpe in reflect the degree of coronary artery stenosis.Based on the positive in Treadmill exercise test,combined with the numerical change(Tpe,Tpec,Tpe/QT)in before and after exercise can improve the positive predictive value,and to provide more objective evidence for coronary heart disease.