Kubo H, Yano K, Hasegawa N, Okura K, Nakamura M, Hase H, Hirai H, Ishida K, Yabuki S, Machii K
Third Department of Internal Medicine, Toho University School of Medicine, Tokyo.
J Cardiol. 1992;22(2-3):375-81.
The effects of exercise training on the restoration of hibernating myocardium after percutaneous transluminal coronary angioplasty (PTCA) were evaluated. Symptom-limited treadmill exercise with thallium-201 myocardial single photon emission CT (SPECT) was performed at one and 13 weeks after PTCA in 15 patients with training and in 15 control patients without training who had no restenosis on repeat angiography. For quantitative analysis, counts for the regions of interest (ROI) were calculated in the hypoperfused area on the polar map. Percent T1 uptake was determined by dividing counts of the hypoperfused area by counts of a normal reference area on the initial image (%IU) and delayed image (%DU). The difference between %DU and %IU, defined as percent redistribution (%RD), was a parameter of residual ischemia in the hypoperfused area. %DU increased significantly in the trained group (65 +/- 11 to 73 +/- 9.3%, p < 0.01) and in the untrained group (66 +/- 14 to 70 +/- 15%, p < 0.05). %RD decreased significantly in the trained group (6.3 +/- 3.2 to 2.8 +/- 2.3%, p < 0.01); whereas, there was no significant change in the untrained group (6.1 +/- 2.8 to 5.2 +/- 3.8%). These findings suggest that, after successful PTCA, exercise training helps alleviate myocardial ischemia, probably by fostering the promoting effects which restore the hibernating myocardium.
评估了运动训练对经皮腔内冠状动脉成形术（PTCA）后冬眠心肌恢复的影响。对15例接受训练的患者和15例未接受训练的对照患者在PTCA术后1周和13周进行了症状限制性平板运动试验及铊-201心肌单光子发射计算机断层扫描（SPECT），这些患者在重复血管造影时均无再狭窄。为进行定量分析，在极坐标图上的灌注不足区域计算感兴趣区（ROI）的计数。通过将灌注不足区域的计数除以初始图像（%IU）和延迟图像（%DU）上正常参考区域的计数来确定T1摄取百分比。%DU与%IU之间的差值，定义为再分布百分比（%RD），是灌注不足区域残余缺血的一个参数。训练组的%DU显著增加（从65±11增至73±9.3%，p<0.01），未训练组也显著增加（从66±14增至70±15%，p<0.05）。训练组的%RD显著降低（从6.3±3.2降至2.8±2.3%，p<0.01）；而未训练组无显著变化（从6.1±2.8降至5.2±3.8%）。这些发现表明，在成功进行PTCA后，运动训练可能通过促进冬眠心肌恢复的作用来帮助减轻心肌缺血。
