Value of dynamic electrocardiogram monitoring in the diagnosis of asymptomatic myocardial ischemia in patients with coronary heart disease

Abstract

Objective To explore the value of dynamic electrocardiogram monitoring in the diagnosis of asymptomatic myocardial ischemia in patients with coronary heart disease. Methods 182 patients with coronary heart disease were selected as study objects. All the patients underwent routine electrocardiogram and dynamic electrocardiogram. The coronary angiography results were set as the gold standard. The diagnostic efficacies of the two methods were compared. Results 119 cases of asymptomatic myocardial ischemia were diagnosed by coronary angiography, and the detection rate was 65.38%. A total of 113 cases (62.10%) of asymptomatic myocardial ischemia were detected by conventional electrocardiogram, and 116 cases (63.70%) by dynamic electrocardiogram. The diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of dynamic electrocardiogram for asymptomatic myocardial ischemia respectively were 85.70%, 77.80%, 83.00%, 87.90%, and 74.20%, which were significantly higher than those of routine electrocardiogram ( 72.30%, 57.10%, 67.00%, 76.10%, and 52.20%, all P<0.05). Kappa consistency test results showed that the consistency between dynamic electrocardiogram and coronary angiography was consistent, and the consistency between conventional electrocardiogram and coronary angiography was moderate. Conclusion Dynamic electrocardiography monitoring has high sensitivity and specificity for asymptomatic myocardial ischemia in patients with coronary heart disease, and the diagnostic accuracy is high. The clinical application has significant advantages. Key words: Asymptomatic myocardial ischemia; Coronary heart disease; Dynamic electrocardiogram; Diagnosis