Application of echocardiography combined with dynamic electrocardiogram in evaluation of coronary heart disease with heart failure
超声心动图联合动态心电图在冠心病伴心力衰竭病情评估的应用

摘要

目的 探究超声心动图联合动态心电图对冠心病伴心力衰竭的诊断价值。方法 选取2019年7月至2020年7月期间因胸痛、胸闷、呼吸不畅就诊的120例疑似冠心病伴慢性心力衰竭患者纳入研究，对所有患者分别实施冠状动脉造影术检查、超声心动图检查以及24h动态心电图检查，将超声心动图检查和动态心电图检查及联合检查结果与冠状动脉造影术检查结果相对比，评估每种检查方式与冠状动脉造影术检查结果的诊断符合率。结果 冠状动脉造影术检查均确诊为冠状动脉粥样硬化患者118例，确诊率为98.33%。动态心电图检查结果显示103例阳性、17例阴性、确诊率为85.33%；超声心动图检查结果显示阳性98例、阴性22例、确诊率81.67%；联合动态心电图和超声心动图检查结果显示，阳性112例，阴性8例，确诊率为93.33%。以冠状动脉造影术检查结果为标准，动态心电图检查的灵敏度为87.29%、特异度11.76%；超声心动图检查灵敏度为83.05%，特异度9.09%；联合检查灵敏度为94.92%、特异度为25.00%，联合检查对冠心病合并心力衰竭的临床诊断价值更高。结论 较单纯超声心动图和动态心电图对冠心病伴心力衰竭的诊断结果相比，联合检查对病情评估更具指导意义。因此，为了提高冠心病伴心力衰竭的临床诊断率，笔者建议可对患者采取无创超声心动图联合动态心电图的检查手段，结合临床症状及患者体征进行综合诊断，以便在最快的时间内为患者提供规范治疗。

Abstract

Objective To explore the diagnostic value of echocardiography combined with dynamic electro- cardiogram in coronary heart disease with heart failure.
Methods a total of 120 patients with suspected coronary heart disease and chronic heart failure due to chest pain, chest tightness and dyspnea from July 2019 to July 2020 were included in the study. Coronary angiography, echocardiography and 24h dynamic electrocardiogram were performed on all patients. The results of echocardiography, dynamic electrocardiogram and combined examinations were compared with the results of coronary angiography to evaluate the diagnostic coincidence rate of each examination method and the results of coronary angiography.
Results 118 patients were diagnosed with coronary atherosclerosis by coronary angiography, the diagnosis rate was 98.33%. The results of dynamic electrocardiogram showed 103 cases were positive, 17 cases were negative, and the diagnosis rate was 85.33%. The results of echo- cardiography showed that 98 cases were positive and 22 cases were negative, and the diagnosis rate was 81.67%. Combined dynamic electrocardiogram and echocardiography showed 112 positive cases and 8 negative cases, with a diagnosis rate of 93.33%. Based on the results of coronary angiography, the sensitivity and specificity of dynamic electrocardiogram were 87.29% and 11.76%. The sensitivity and specificity of echocardiography were 83.05% and 9.09%. The sensitivity and specificity of combined examination were 94.92% and 25.00%, indicating that combined examination had higher clinical diagnostic value for CHD complicated with heart failure.
Conclusion   Compared with echocardiography and electrocardiogram alone, combined examination has more guiding signify- cance in the diagnosis of CHD with heart failure. Therefore, in order to improve the clinical diagnosis rate of CHD with heart failure, the author suggests that non-invasive echocardiography combined with dynamic electrocar- diogram can be adopted for patients, combining clinical symptoms and patient signs for comprehensive diagnosis, so as to provide standardized treatment for patients in the fastest time.