Barmeyer A, Meinertz T
Department of Cardiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Cardiology. 2002;98(3):127-31. doi: 10.1159/000066320.
In this study, we investigated the effect of percutaneous transluminal coronary angioplasty (PTCA) on functional exercise capacity, oxygen uptake at anaerobic threshold (VO(2 AT)) and maximal oxygen uptake (VO(2 max)) in patients with coronary artery disease (CAD). Twenty-five patients with CAD and stable angina pectoris underwent spiroergometry before and after PTCA. All patients had reduced functional capacity with Weber class B in 5, class C in 16 and class D in 4 patients with mean VO(2 AT) of 9.4 +/- 1.5 ml.kg(-1).min(-1) and mean VO(2 max) of 13.3 +/- 3.3 ml. kg(-1).min(-1). After PTCA, VO(2 max) (15.8 +/- 3.1 ml.kg(-1). min(-1)) increased significantly (p < 0.001) compared to before PTCA. Subgroup analysis revealed that patients with low functional capacity before PTCA (VO(2 max) <15 ml x kg(-1) x min(-1)) had the most benefit from PTCA with an increase in VO(2 AT) from 8.7 +/- 1.0 to 9.6 +/- 1.4 ml x kg(-1) x min(-1) (p < 0.05) and of VO(2 max) from 11.3 +/- 2.2 to 14.8 +/- 3.5 ml x kg(-1) x min(-1) (p < 0.001) whereas in patients with VO(2 max) >15 ml x kg(-1) x min(-1), VO(2 AT) (p = 0.9) and VO(2 max) (p = 0.2) did not improve significantly. In conclusion, there is reduced functional capacity and VO(2 max) which improved after PTCA in CAD patients. In patients with low VO(2 max) before PTCA, functional capacity, VO(2 AT) and VO(2 max) significantly improved after PTCA, suggesting reversible myocardial impairment induced by intermittent myocardial ischemia. Patients with higher VO(2 max) had no significant benefit from PTCA with respect to functional capacity, VO(2 max) and VO(2 AT).
在本研究中，我们调查了经皮腔内冠状动脉成形术（PTCA）对冠状动脉疾病（CAD）患者功能运动能力、无氧阈摄氧量（VO₂AT）和最大摄氧量（VO₂max）的影响。25例患有CAD且稳定型心绞痛的患者在PTCA前后接受了运动心肺功能测试。所有患者的功能能力均降低，其中5例为Weber B级，16例为C级，4例为D级，平均VO₂AT为9.4±1.5 ml·kg⁻¹·min⁻¹，平均VO₂max为13.3±3.3 ml·kg⁻¹·min⁻¹。PTCA后，VO₂max（15.8±3.1 ml·kg⁻¹·min⁻¹）较PTCA前显著增加（p<0.001）。亚组分析显示，PTCA前功能能力较低（VO₂max<15 ml·kg⁻¹·min⁻¹）的患者从PTCA中获益最大，VO₂AT从8.7±1.0增加到9.6±1.4 ml·kg⁻¹·min⁻¹（p<0.05），VO₂max从11.3±2.2增加到14.8±3.5 ml·kg⁻¹·min⁻¹（p<0.001），而VO₂max>15 ml·kg⁻¹·min⁻¹的患者，VO₂AT（p = 0.9）和VO₂max（p = 0.2）没有显著改善。总之，CAD患者的功能能力和VO₂max降低，PTCA后有所改善。PTCA前VO₂max较低的患者，其功能能力、VO₂AT和VO₂max在PTCA后显著改善，提示间歇性心肌缺血诱导的可逆性心肌损伤。VO₂max较高的患者在功能能力、VO₂max和VO₂AT方面从PTCA中未获得显著益处。
