Stojan M, Boudík F, Vojácek J, Bultas J, Vondrácek V, Stovícek P, Anger Z, Charvát A
Kardiologická laborator 1. LF Univerzity Karlovy, Praha.
Vnitr Lek. 1992 May;38(5):448-57.
The authors describe the clinical picture and results of some auxiliary examinations in 18 patients with the X syndrome, i.e. with angina pectoris with a normal angiographic finding on the coronary arteries. For the diagnosis of ischemic cardiac changes, which are an integral part of this syndrome, the authors used a complex analysis of the electric cardiac field by means of a Cardiac 128.1 apparatus (manufactured by ZPA-Cakovice). In patients with the X syndrome they observed a significant reduction of some potential and integral values, as compared with an equally sized group of healthy subjects. On maps of the electric manifestation of cardiac activity on the chest surface ischemic changes were revealed on the antrior and lower cardiac wall but also in its lateral and posterior wall. These changes were older and were found in the subendocardial layer or concurrently in another area of the heart with affection of the subepicardial layer. Minor non-transmural fibroses, most frequently on the septum, in some instances spreading to the anterior and lower cardiac wall, were a surprising finding. At present it is not possible to differentiate merely by analysis of the electric cardiac field the X syndrome and ischemic heart disease. This should be made possible by further comparative studies. The present paper is the first description of ischemic and fibrous cardiac changes in X syndrome diagnosed by a complex analysis of the electric cardiac field in the professional literature published in Czechoslovakia and other countries.
作者描述了18例X综合征患者的临床表现及一些辅助检查结果，即患有冠状动脉造影正常的心绞痛。为诊断作为该综合征组成部分的缺血性心脏改变，作者使用Cardiac 128.1仪器（由ZPA - Cakovice制造）对心脏电场进行了综合分析。与同等规模的健康受试者组相比，他们在X综合征患者中观察到一些电位和积分值显著降低。在胸壁心脏活动电表现图上，在前壁、下壁以及侧壁和后壁均发现了缺血性改变。这些改变出现时间较早，见于心内膜下层，或同时出现在心脏其他区域且伴有心外膜下层受累。少数非透壁性纤维化，最常见于室间隔，某些情况下蔓延至心脏前壁和下壁，这是一个令人惊讶的发现。目前仅通过心脏电场分析无法区分X综合征和缺血性心脏病。这需要通过进一步的比较研究来实现。本文是捷克斯洛伐克及其他国家专业文献中首次通过心脏电场综合分析诊断X综合征时对缺血性和纤维性心脏改变的描述。
