Matsuo H, Watanabe S, Nishida Y, Kanoh M, Matsubara T, Sugiyama A, Matsuno Y, Oda H, Kotoo Y, Oohashi H
Division of Cardiology and Nephrology, Prefectural Gifu Hospital.
Kaku Igaku. 1992 Nov;29(11):1269-76.
The prevalence of silent myocardial ischemia was retrospectively assessed in a group of 100 consecutive patients with angiographically proved coronary artery disease, and diagnostic ECG, by symptom-limited exercise thallium-201 scintigraphy. Twenty-four patients had no evidence of ischemia despite adequate exercise level. So among 76 patients with exercise induced ischemia, only 33 patients (43%) stopped exercise due to anginal pain (symptomatic ischemia: Group 3). And 43 patients with asymptomatic ischemia composed of 23 patients (30%) with ECG change (Group 2B) and 20 patients (26%) without ECG change (Group 2A). Patients background including the history of old myocardial infarction and diabetes mellitus, were similar among Group 2A, 2B, and Group 3. And our major observation was that the extent and severity of quantified SPECT perfusion defects was nearly identical between 3 groups Thus in this study group, there was a rather high prevalence rate of silent ischemia (57%) by exercise thallium-201 criteria. Patients with silent ischemia, associated with positive and negative exercise ECG findings, and those with exercise angina had similar background and comparable amount of jeopardized myocardium.
通过症状限制性运动铊-201心肌显像，对连续100例经血管造影证实患有冠状动脉疾病且进行了诊断性心电图检查的患者进行回顾性评估，以确定无症状心肌缺血的患病率。24例患者尽管运动水平足够，但未发现缺血证据。因此，在76例运动诱发缺血的患者中，只有33例患者（43%）因心绞痛而停止运动（有症状缺血：第3组）。43例无症状缺血患者包括23例（30%）有心电图改变的患者（第2B组）和20例（26%）无心电图改变的患者（第2A组）。第2A组、第2B组和第3组患者的背景，包括陈旧性心肌梗死病史和糖尿病史，相似。我们的主要观察结果是，三组之间定量SPECT灌注缺损的范围和严重程度几乎相同。因此，在该研究组中，根据运动铊-201标准，无症状缺血的患病率相当高（57%）。伴有运动心电图阳性和阴性结果的无症状缺血患者以及运动性心绞痛患者具有相似的背景和相当数量的濒危心肌。
