Patent RU-2270599-C2 (RU)
Inventor: KORJAKOV ANATOLIJ IVANOVICH
IPC: A61B10/00
Filed: 2004-09-10
Granted: 2006-02-27
Abstract: FIELD: medicine. 
     SUBSTANCE: method involves applying single load test on no medicament consumption background. The load test is aimed at reach maximum age-specific heart beat rate and/or marked general fatigue and/or intensive anginous-like pain. Subjective signs of myocardial ischemia are estimated in scores. Score 2 is assigned if patient sensations are typical for exertional angina pectoris. Score 1 is assigned if patient sensations are doubtful from the angina pectoris point of view. Score 0 is assigned if patient sensations are completely atypical for exertional angina pectoris. The grades of patient sensations being typical for angina pectoris are estimated using a special table. Score estimates are determined for changes in ST-segment of electrocardiogram, arterial blood pressure dynamics and cardiac rhythm. Score 2 is assigned if detected signs are highly specific for cardiac ischemia disease. Score 1 is assigned if the detected signs are of moderate specificity for cardiac ischemia disease. Score 0.5 is assigned if the signs are of low specificity for cardiac ischemia disease. Score 0 is assigned if the detected signs are not specific for cardiac ischemia disease. The grades of specificity degree with respect to changes in ST-segment of electrocardiogram, arterial blood pressure dynamics and cardiac rhythm are estimated using a special table. Next to it, integral score estimate of load test is calculated by summing up scores of changes in electrocardiogram ST-segment and scores of arterial blood pressure dynamics. Modified integral score estimate is calculated by summing up scores of changes in electrocardiogram ST-segment, scores of arterial blood pressure dynamics and scores of cardiac rhythm changes. The load test being brought to maximum age-specific heart beat rate and/or marked general fatigue and/or intensive anginous-like pain and the integral score estimate being equal to 4, categorical conclusion is drawn concerning cardiac ischemia disease in the form of exertional angina pectoris; the integral score estimate being between 2 and 3.5, conclusion is drawn with high probability level concerning cardiac ischemia disease in the form of exertional angina pectoris; the integral score estimate being between 0.5 and 1.5, exertional angina pectoris diagnosis is rejected with high probability level. The integral score estimate being equal to 0 the angina pectoris diagnosis is rejected with probability of 100%. The modified integral score estimate being greater than 3.5, categorical conclusion is drawn concerning hemodynamically significant coronary atherosclerosis and cardiac ischemia disease diagnosis is set with probability of 100%. The modified integral score estimate being between 2 and 3.5, hemodynamically significant coronary atherosclerosis diagnosis is considered to be of high probability degree. The modified integral score estimate being between 0.5 and 1.5, hemodynamically significant coronary atherosclerosis diagnosis is considered to be of low probability degree. The modified integral score estimate value being equal to 0, the coronary atherosclerosis diagnosis is excluded with 100% of probability. The load test not being brought to maximum age-specific heart beat rate and/or marked general fatigue and/or intensive anginous-like pain and the integral score estimate being between 2 and 4, conclusion is drawn with high probability level concerning cardiac ischemia disease in the form of exertional angina pectoris; the value being between 0 and 1.5, the diagnosis is rejected with high probability level; the modified integral score estimate being not less than 2, hemodynamically significant coronary atherosclerosis is considered to be diagnosed with high probability; the value being between 0 and 1.5, hemodynamically significant coronary atherosclerosis is to be diagnosed with low probability. The modified integral score estimate being not less than 2 in combination with the integral score estimate being less than 2, cardiac ischemia disease in the form of isolated painless myocardial ischemia is to be diagnosed with high probability. 
     EFFECT: high reliability of cardiac ischemia disease diagnosis with single load test. 
     4 cl, 9 tbl