CRCardiovascular Reviews3083-48802981-8109Bio-Byword Scientific Publishing Pty. Ltd.10.26689/cr.v3i2.9702ArticleComparison of the Application Value of Treadmill Exercise Test and Dynamic Electrocardiogram in the Diagnosis of Coronary Heart Diseasehttps://artdesignp.com/journal/CR/3/2/10.26689/cr.v3i2.9702YaqianHuang2025322025-07-02Objective: To explore the application value of treadmill exercise test and dynamic electrocardiogram in diagnosing coronary heart disease. Methods: A total of 185 patients with suspected coronary heart disease admitted to the Department of Electrocardiography in Wujia District of Central People’s Hospital from February 2023 to February 2024 were selected according to the inclusion and exclusion criteria, including 93 males and 92 females, aged from 38 to 75 years, with an average age of (55.86 ± 3.25) years. Treadmill exercise test and dynamic electrocardiogram were performed on all patients, and the results of coronary angiography were used as the gold standard. Results: The results of coronary angiography in 185 patients showed that 148 patients were diagnosed as positive, accounting for 80%. The coronary heart disease detection rate in the treadmill exercise test group was 97.30%, which was significantly higher than that in the Holter group, and the difference was statistically significant (P < 0.05). The accuracy, specificity, sensitivity, positive predictive value, and negative predictive value of the treadmill exercise test group were 95.68%, 89.19%, 97.30%, 97.30%, and 89.19%, respectively, which were significantly higher than those of the Holter group (P < 0.05). The misdiagnosis rate and missed diagnosis rate of the treadmill exercise test group were 10.81% and 2.70%, which were significantly lower than those of the dynamic electrocardiogram group, and the difference was statistically significant (P < 0.05). Conclusion: Both treadmill exercise testing and Holter have unique advantages and limitations. In clinical practice, treadmill exercise testing has a high application value in the diagnosis of coronary heart disease and can effectively reduce the misdiagnosis rate.

Li H, Li B, Cao Z, et al., 2024, The Diagnostic Value of the Modified STdmax/MET Criterion in Treadmill Exercise Electrocardiographic Test for Coronary Artery Disease in an Aged Population. Alternative Therapies in Health and Medicine, (3): AT10034.

Pintaningrum Y, Adipranoto D, Pramana K, 2024, Correlation Between Simplified Treadmill Score, Significantly Stenosed Blood Vessels and SYNTAX Score in CAD. The British Journal of Cardiology, 31(3): 028.

Melnychuk OI, Sharayeva LM, Bondarchuk MO, et al., 2024, Holter ECG Monitoring and Platelets Characteristics in Patients With Coronary Artery Disease and Atrial Fibrillation. Wiadomosci Lekarskie (Warsaw, Poland : 1960), 77(5): 957–964.

Lin Y, 2023, Relationship Between Dynamic Electrocardiogram and CRP, IL-6, ET-1 Expression in Myocardial Ischemia Patients With Coronary Heart Disease. Cellular and Molecular Biology (Noisy-le-Grand, France), 69(12): 52–56.

MDL, Sanjay D, Ankur G, et al., 2021, Role of Exercise Treadmill Testing in the Assessment of Coronary Microvascular Disease. JACC. Cardiovascular Imaging, 15(2): 312–321.

Magdalena F, Paweł R, Jacek Ł, et al., 2017, Evaluation of Sleep Apnea, Detected by 24-Hour ECG Holter Monitoring Analysis in Patients With Stable Coronary Artery Disease and Ischemic Heart Failure – Correlations With Clinical Data. Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego, 42(252): 231–235.

Wenrong W, Qiang Z, 2021, Diagnostic Value of Scoring Model of Treadmill Exercise Test Combined With Dynamic Electrocardiogram for Latent Coronary Heart Disease. Journal of Electrocardiology, 69(prepublish): 82–86.

Naping L, Rongcheng Z, 2020, Effect of Coronary Computed Tomography Angiography Combined With Treadmill Exercise Test on the Recovery of Patients With Coronary Heart Disease. Basic & Clinical Pharmacology & Toxicology, 127: 153–153.

Sultan I, Mohammed A, Ali A, 2019, Exercise Treadmill Test Findings in Patients With Coronary Artery Disease in Salahaddin General Hospital, Tikrit, Iraq. Indian Journal of Forensic Medicine & Toxicology, 13(4): 276–282.

Kun D, Wentao C, Xiaoling J, et al., 2023, Analysis of Skin Cholesterol Determination Combined with ECG Treadmill Exercise in Diagnosis of Coronary Heart Disease in Patients with Atypical Chest Pain. Journal of Practical Medicine / Shiyong Yixue Zazhi, 39(20): 51–56.

NPK, JBA, Jiwon K, et al., 2019, Impact of Mitral Regurgitation Severity and Cause on Effort Tolerance–Integrated Stress Myocardial Perfusion Imaging and Echocardiographic Assessment of Patients With Known or Suspected Coronary Artery Disease Undergoing Exercise Treadmill Testing. Journal of the American Heart Association, 8(5): e010974.

Yang B, Jia Z, 2024, Diagnostic Value of Nocturnal Trend Changes in a Dynamic Electrocardiogram for Coronary Heart Disease. BMC Cardiovascular Disorders, 24(1): 561–561.

International ME, 2024, Retracted: Application of 24 h Dynamic Electrocardiography in the Diagnosis of Asymptomatic Myocardial Ischemia With Arrhythmia in Elderly Patients With Coronary Heart Disease. Emergency Medicine International, (7): 9861978–9861978.

Qiu X, Liu R, Ren S, 2024, Interventional Effect Analysis of 24-Hour Dynamic Electrocardiogram on Coronary Heart Disease Arrhythmias and Ischemic Myocardium. Journal of Biotech Research,24(2): 171–180.

Mathematical ACMIM, 2023, Retracted: Meta-Analysis of Dynamic Electrocardiography in the Diagnosis of Myocardial Ischemic Attack of Coronary Heart Disease. Computational and Mathematical Methods in Medicine, (9): 9838452–9838452.

Zongwei C, Hong T, Xuemei L, et al., 2022, Application of 24 h Dynamic Electrocardiography in the Diagnosis of Asymptomatic Myocardial Ischemia With Arrhythmia in Elderly Patients With Coronary Heart Disease. Emergency Medicine International, (14): 3228023–3228023.

Wenting R, 2022, Meta-Analysis of Dynamic Electrocardiography in the Diagnosis of Myocardial Ischemic Attack of Coronary Heart Disease. Computational and Mathematical Methods in Medicine,7(12): 3472413–3472413.

Haitao S, Jing L, Yue W, et al., 2022, Effect of Mobile Internet on Attitude and Self-Efficacy of Patients With Coronary Heart Disease Diagnosed by 12-Lead Holter ECG. Journal of Healthcare Engineering, (2) 3414178–3414178.

Pylova T, 2021, Results of Holter Monitoring in Patients With Coronary Heart Disease Depending on the Severity of Atherosclerotic Lesions of the Coronary Arteries. ScienceRise: Medical Science, 2021(3): 15–19.

Gupta G, Raina S, Bhatnagar M, et al., 2023, Usefulness of Exercise Stress Test in Early Diagnosis of Coronary Artery Disease in Diabetic Patients. Journal of Medical Society, 37(1): 20–25.