Sažetak | Cilj ovog istraživanja bio je ispitati učinkovitost kardiogoniometrije, novije, neinvazivne
metode u dijagnostici koronarne bolesti u žena i usporediti je s ergometrijom, koristeći
koronarografiju kao referentnu metodu.
Metode i materijali: Riječ je o unicentričnom, prospektivnom istraživanju sastavljenom od
serije slučajeva u koje su bile uključene žene sa simptomima stabilne angine pektoris kojima
je učinjena koronarografija. Ergometrija, izvedena prema protokolu po Bruceu, kao i
kardiogoniometrija izvedene su prije koronarografije. Klinički značajna koronarna bolest je
definirana kao stenoza > 70% jedne ili više koronarnih arterija.
Rezultati: U istraživanje je uključeno 114 uzastopnih bolesnica s medijanom dobi 64,0 (58,0-
71,0), od kojih su 32 (28,1%) imale koronarnu bolest. Kardiogoniometrija je pokazala ukupnu
učinkovitost 74,6% s osjetljivošću 75,0% (95% CI 56,6-88,5%) i specifičnošću 74,4% (95%
CI 63,6-83,4%). Ergometrija je pokazala ukupnu učinkovitost 45,1% s osjetljivošću 68,1%
(95% CI 42,7-83,6%) i specifičnošću 36,6% (95% CI 25,2-50,3%). Kardiogoniometrija je
pokazala veću učinkovitost u usporedbi s ergometrijom (p< 0,001). Patološki nalaz
kardiogoniometrije je bio povezan s gotovo 9 puta većim rizikom koronarne bolesti (omjer
rizika 8,7, 95% CI 3.4-22.3, p< 0,001), koji je ostao značajan i nakon prilagodbe za dob i
hipokineziju.
Zaključak: Kardiogoniometrija je neinvazivna metoda, jednostavna za korištenje i bez rizika
komplikacija, koja je pokazala visoku učinkovitost u dijagnostici stabilne koronarne bolesti u
žena i superiornost u odnosu na ergometriju. Kardiogoniometrija bi mogla postati dio
dijagnostičkog algoritma za probir žena sa stabilnom koronanom bolesti te je pogodna za
korištenje u primarnoj zdravstvenoj zaštiti, osobito u žena koje ne mogu podnijeti/izvršiti
fizičko opterećenje. |
Sažetak (engleski) | Aim of this study was to investigate the efficiency of cardiogoniometry, a novel, non-invasive
method, in diagnosing coronary artery disease (CAD) in women and compare it with exercise-
ECG test, by using coronary angiography as a reference method.
Methods and materials: It was a single-centre, case-series study including consecutive female
patients with stable angina pectoris symptoms undergoing coronary angiography. Exercise-
ECG test, done according to the Bruce protocol, and cardiogoniometry were obtained prior to
coronary angiography. Clinically significant CAD has been defined as one or more coronary
lesions with > 70% stenosis.
Results: Study included 114 consecutive female patients with median age of 64.0 (58.0-71.0),
out of which 32 (28.1%) had CAD. Cardiogoniometry yielded a total accuracy of 74.6% with
a sensitivity of 75.0% (95% CI 56.6 - 88.5%) and specificity of 74.4% (95% CI 63.6-83.4%).
Exercise-ECG test yielded a total accuracy of 45.1% with a sensitivity of 68.1% (95% CI 42.7-
83.6%) and specificity 36.6% (95% CI 25.2-50.3%). CGM showed higher accuracy than
exercise-ECG test (p< 0.001). Pathological cardiogoniometry was associated with almost 9
times higher risk for CAD (OR 8.7, 95% CI 3.4-22.3, p< 0.001), which remained significant
after adjustment for age and hypokinesia.
Conclusion: Cardiogoniometry is a non-invasive, easy-to-use and risk-free method which
showed high efficiency in diagnosing stable CAD in women and is superior to exercise-ECG
test. Cardiogoniometry could be introduced as a part of the diagnostic algorithm of screening
women for stable CAD and is suitable for use in the primary setting, especially in women
unable to undergo stress-testing. |