Helfant R H, DeVilla M A, Banka V S
Cathet Cardiovasc Diagn. 1976;2(1):59-67. doi: 10.1002/ccd.1810020108.
The usefulness of isometric handgrip exercise in the assessment of left ventricular function was studied in 27 patients, all of whom had angiographically documented coronary artery disease. The effect of extensiveness of coronary disease and presence or absence of collaterals (both delineated by coronary arteriography) on the response to handgrip stress was also evaluated. Of 11 patients with a normal handgrip response, 4 exhibited a normal left ventriculogram and 7 were abnormal. Of these 7, 6 had inferior hypokinesis. Conversely, of 16 patients with an abnormal response to handgrip, 15 had abnormal ventriculograms. Of these, 9 had anterior akinesis. Of patients with a normal handgrip response 82% had two- or three-vessel coronary disease, and 94% with an abnormal response exhibited two- or three-vessel obstruction. There was no observed correlation between the presence or absence of collaterals and the response to handgrip. This study indicates that (1) handgrip stress, when combined with left ventriculography, often yields important additional information regarding the effect of localized contraction abnormalities on overall left ventricular performance; (2) the extent of coronary obstructive disease or the presence of collaterals per se do not appear to be the primary determinants of left ventricular performance; (3) it is possible that the location as well as severity and extent of left ventricular contraction abnormality may play an important role in determining overall left ventricular performance.
对27例患者进行了等长握力运动在评估左心室功能方面的实用性研究，所有患者均经冠状动脉造影证实患有冠状动脉疾病。还评估了冠状动脉疾病的范围以及侧支循环的有无（均通过冠状动脉造影确定）对握力应激反应的影响。在握力反应正常的11例患者中，4例左心室造影正常，7例异常。在这7例异常患者中，6例有下壁运动减弱。相反，在握力反应异常的16例患者中，15例左心室造影异常。其中，9例有前壁运动不能。握力反应正常的患者中，82%患有双支或三支冠状动脉疾病，握力反应异常的患者中，94%表现为双支或三支血管阻塞。未观察到侧支循环的有无与握力反应之间存在相关性。本研究表明：（1）握力应激与左心室造影相结合时，常常能提供有关局部收缩异常对整体左心室功能影响的重要附加信息；（2）冠状动脉阻塞性疾病的范围或侧支循环的有无本身似乎并非左心室功能的主要决定因素；（3）左心室收缩异常的部位以及严重程度和范围可能在决定整体左心室功能方面起重要作用。
