Chandramouli B, Ehmke D A, Lauer R M
J Pediatr. 1975 Nov;87(5):725-30. doi: 10.1016/s0022-3476(75)80295-2.
The relationship of exercise-induced electrocardiographic changes to severity of obstruction in congenital aortic stenosis was studied in 44 children. Twelve subjects, with ST segment depression of 1 mm or more lasting 0.08 seconds after the J Point, had left ventricular-aortic peak systolic pressure differences (gradients) ranging from 54 to 112 mm Hg. The remaining 32 children had less than 1 mm or no ST segment depression. Thirty-one of these had gradients ranging from 10 to 48 mm Hg and one had a gradient of 52 mm Hg. Vectorcardiograms, electrocardiograms, and chest roentgenograms were not useful in the identification of the severity of the lesion. The study suggests that children with severe gradients develop electrocardiographic ST segment changes with exercise, thereby helping to select those patients who should have catheterization studies to delineate the severity of the lesion. In those with a normal exercise test, cardiac catheterization may be safely delayed, but the exercise test should be repeated to identify those who develop progressive obstruction.
对44名儿童进行了运动诱发心电图变化与先天性主动脉瓣狭窄梗阻严重程度之间关系的研究。12名受试者在J点后ST段压低1mm或更多且持续0.08秒，其左心室-主动脉收缩压峰值差（压差）在54至112mmHg之间。其余32名儿童ST段压低小于1mm或无ST段压低。其中31名压差在10至48mmHg之间，1名压差为52mmHg。向量心电图、心电图和胸部X线片对病变严重程度的识别并无帮助。该研究表明，压差严重的儿童运动时会出现心电图ST段变化，从而有助于筛选出那些应进行心导管检查以明确病变严重程度的患者。对于运动试验正常的患者，心导管检查可安全推迟，但应重复运动试验以识别那些出现进行性梗阻的患者。
