ABSTRACT
Objective:
To explore the clinical value of synchronized 12-
lead Holter in the
diagnosis of
coronary heart disease myocardial ischemia.
Methods:
A total of 101
patients with
coronary heart disease who came to the Affiliated
Hospital of Jining Medical College from May 2019 to May 2020 were selected. They all received conventional
electrocardiogram(
ECG) and synchronized 12-
lead Holter examinations. The value of different examination
methods in the
diagnosis of
myocardial ischemia was compared, and the characteristics of
myocardial ischemia in
patients with different degrees of
coronary artery disease were analyzed.
Results:
The
detection rates of synchronized 12-
lead Holter for
myocardial ischemia in single-vessel
coronary artery disease and multi-vessel
coronary artery disease were 28.71% (29/101) and 56.44%(57/101), respectively, which were slightly higher than 17.82%(18/101) and 45.54% (46/101) of conventional
ECG, but with no statistically significant difference ( P>0.05), the total
myocardial ischemia detection rate of synchronized 12-
lead Holter was 85.15%(86/101), which was higher than 63.37%(64/101) of conventional
ECG ( P<0.05). The mean frequency of
myocardial ischemia in
coronary heart disease diagnosed by synchronized 12-
lead Holter was higher than that of conventional
ECG, and the duration and amplitude of ST-segment
depression were higher than those in conventional
ECG ( P<0.05). The
detection rates of lateral and inferior
myocardial ischemia on synchronized 12-
lead Holter were 16.28%(14/86) and 22.09%(19/86), respectively, which were higher than 0 of conventional
ECG. The
detection rate of
myocardial ischemia in the anterior septum/anterior wall was 61.62%(53/86), which was lower than 100.00% (64/64)of the conventional
ECG ( P<0.01). Synchronized 12-
lead Holter in the
diagnosis of coronary cardiac
myocardial ischemia was highly consistent with that by
coronary angiography, the Kappa value was 0.648, and the
sensitivity,
specificity, accuracy and
negative predictive value were 93.33%, 81.82%, 92.08% and 60.00%, respectively, which were higher than 54.44%, 63.64%, 55.45%, 14.58% of conventional
ECG ( P<0.05). The number of myocardial ischemic attacks in
patients with multi-vessel
disease of
coronary heart disease was more than that of single vessel
disease ( P<0.05), the mean frequency of
myocardial ischemia was higher than that of single vessel
disease, and the duration and amplitude of ST-terminal
depression were higher than those of
patients with single-vessel
disease ( P<0.05).
Conclusions:
Synchronized 12-
lead Holter is more effective than conventional
ECG in the
diagnosis of myocardial ischemic attack of
coronary heart disease, and it is more consistent with
coronary angiography. It can clarify the frequency and extent of myocardial ischemic attacks and help identify the
location of
myocardial ischemia. It can be used as an important basis for
screening myocardial ischemia attacks of
coronary heart disease.