Exploring the clinical value of combining coronary artery CTA and dynamic electrocardiogram for the diagnosis of myocardial ischemia in coronary heart disease
Objective To explore the clinical value of combining coronary angiography(CTA)and dynamic electrocardiogram for the diagnosis of myocardial ischemia in coronary heart disease.Methods A total of 68 patients with highly suspected coronary heart disease and myocardial ischemia admitted to Linyi Central Hospital from January 2022 to February 2023 were selected.All patients received coronary CTA and holter electrocardiogram examination,and coronary angiography results were used as the"gold standard"for diagnosis.To compare the diagnostic efficacy of coronary artery CTA and holter electrocardiogram alone and combined,and compare the parameters of diseased and normal myocardium perfusion.Results Using coronary angiography results as the diagnostic gold standard,a total of 42 cases of coronary heart disease myocardial ischemia were detected in 68 patients;Coronary CTA detected 36 cases of coronary heart disease with myocardial ischemia,12 cases were missed,6 cases were misdiagnosed,and the Kappa value was 0.463.Dynamic electrocardiogram detected 35 cases of coronary heart disease with myocardial ischemia,11 cases were missed,4 cases were misdiagnosed,and the Kappa value was 0.556.Joint examination detected 42 cases of coronary heart disease with myocardial ischemia,3 cases were missed and 3 cases were misdiagnosed,with a Kappa value of 0.813;The accuracy and sensitivity of the combined examination of coronary artery CTA and dynamic electrocardiogram were higher than those of coronary artery CTA and dynamic electrocardiogram(P＜0.05).The QRS duration of myocardial ischemia was lower than that of non myocardial ischemia patients(P＜0.05).Conclusion The combination of coronary artery CTA and dynamic electrocardiogram examination has good clinical value for the diagnosis of myocardial ischemia in coronary heart disease.
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