Tsuji H, Iwasaka T, Sugiura T, Shimada T, Nakamori H, Kimura Y, Inada M
Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
Am Heart J. 1991 Jun;121(6 Pt 1):1679-84. doi: 10.1016/0002-8703(91)90012-7.
The relationship between myocardial ischemia detected by exercise thallium-201 scintigraphy and repetitive ventricular premature beats (VPBs) during ambulatory monitoring was evaluated in 57 patients with recent myocardial infarction. Multivariate analysis was performed to obtain the relatively important factor related to repetitive VPBs with the use of the following variables: age, redistribution, left ventricular ejection fraction, serum potassium and magnesium concentration, QRS score, left ventricular aneurysm, and the number of diseased vessels. Thirty-five patients had redistribution, but only three of them had repetitive VPBs during exercise testing. The average heart rate before 79% of 398 episodes of repetitive VPBs during ambulatory monitoring was in the range of 56 to 70/min. These data indicate that most of repetitive VPBs during ambulatory monitoring were not provoked by exercise-induced acute myocardial ischemia. However, redistribution was found to be an important factor associated with repetitive VPBs. The electrical abnormality relating to a substrate characterized by chronic reversible ischemia may explain the association between redistribution and repetitive VPBs.
在57例近期发生心肌梗死的患者中，评估了运动铊-201闪烁显像检测到的心肌缺血与动态监测期间重复性室性早搏（VPB）之间的关系。采用以下变量进行多因素分析，以获得与重复性VPB相关的相对重要因素：年龄、再分布、左心室射血分数、血清钾和镁浓度、QRS评分、左心室室壁瘤以及病变血管数量。35例患者出现再分布，但其中只有3例在运动试验期间出现重复性VPB。在动态监测期间398次重复性VPB发作中，79%之前的平均心率在56至70次/分钟范围内。这些数据表明，动态监测期间的大多数重复性VPB并非由运动诱发的急性心肌缺血所引发。然而，发现再分布是与重复性VPB相关的一个重要因素。与以慢性可逆性缺血为特征的基质相关的电异常可能解释再分布与重复性VPB之间的关联。
