Irace L, Guadagno I, Cice G, Citro R, Di Stasio M, Mottola M, Ricciardi L, Sannino A, Cocchia R, Iacono A
Cattedra di Cardiologia, I Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli Federico II.
Minerva Cardioangiol. 1992 Jul-Aug;40(7-8):251-7.
In evaluating the significance of arrhythmias and ECG changes during exercise, 42 consecutive patients (pts) with mitral valve prolapse (MVP) underwent a symptom-limited cycloergometer Exercise Stress Test (EST) with load increase of 25 watts every 3 minutes. Eight patients (19%) were positive for anamnestic cardiopalm. The patients were divided in 2 groups, according to echocardiographic evidence of the MPV: group A (12 patients, mean age 32 +/- 13) with prolapse of one mitral leaflet and group B (30 patients, mean age 30 +/- 13) with prolapse of both mitral leaflets. Exercise duration doesn't differ significantly in the two groups. No arrhythmias during EST were found in group A, while arrhythmias were present in 6 patients (20%) in group B. A strong correlation was found between anamnestic cardiopalm and arrhythmias during EST (6/8 = 75%). Three of four patients (75%) with ST impairment during EST, showed at thallium myocardial scintigraphy a non reversible perfusion defect after exercise. These data showed a higher incidence of arrhythmias during EST in patients with MVP of both leaflets and good relationship with symptomatology of cardiopalm.
在评估运动期间心律失常和心电图变化的意义时,42例连续的二尖瓣脱垂(MVP)患者接受了症状限制性的蹬车运动应激试验(EST),负荷每3分钟增加25瓦。8例患者(19%)有既往心悸史阳性。根据MVP的超声心动图证据,将患者分为2组:A组(12例患者,平均年龄32±13岁)为一个二尖瓣叶脱垂,B组(30例患者,平均年龄30±13岁)为两个二尖瓣叶脱垂。两组的运动持续时间无显著差异。A组在EST期间未发现心律失常,而B组有6例患者(20%)出现心律失常。既往心悸史与EST期间的心律失常之间存在很强的相关性(6/8 = 75%)。4例EST期间有ST段损害的患者中,有3例(75%)在运动后铊心肌闪烁显像显示不可逆灌注缺损。这些数据表明,双叶MVP患者在EST期间心律失常的发生率较高,且与心悸症状有良好的相关性。