Fukushima K
Third Department of Internal Medicine, Toho University School of Medicine.
Kokyu To Junkan. 1991 Nov;39(11):1145-50.
The purpose of this study was to evaluate the capability of treadmill exercise testing early after percutaneous transluminal coronary angioplasty (PTCA) for prediction of restenosis during the follow-up period. Subjects were comprised of 30 patients with single vessel disease, in whom angiographic success immediately after PTCA was obtained. Follow-up coronary angiography at a mean of 3.5 months after initial PTCA demonstrated restenosis in 15 patients. Treadmill exercise testing was conducted before PTCA (pre-EX), at a mean of 11 days after PTCA (early-EX), and at a mean of 3.2 months after PTCA (late-EX). The degree of residual stenosis immediately after PTCA measured using videodensitometry was similar in both the groups with and without restenosis. In the non-restenosis group, Functional aerobic impairment (FAI), myocardial aerobic impairment (MAI), and heart rate impairment (HRI) measured in the early-EX period improved significantly compared to that in the pre-EX period (p less than 0.05, p less than 0.01, and p less than 0.05, respectively). There were no significant changes in the restenosis group. Using exercise parameters before and soon after PTCA, a discriminant analysis was made between these groups. The formula was defined as follows; Z = 0.0178 x (FAI of pre-EX) +0.0543x (FAI of early-EX) +0.0513x (MAI of pre-EX) -0.1056x (MAI of early-EX) -0.3135. Under this formula, 14 of the 17 patients with Z less than 0 had restenosis during the follow-up period.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是评估经皮腔内冠状动脉成形术(PTCA)后早期进行跑步机运动试验对随访期再狭窄的预测能力。研究对象包括30名单支血管病变患者,这些患者PTCA术后立即获得了血管造影成功。初次PTCA后平均3.5个月的随访冠状动脉造影显示,15例患者出现再狭窄。在PTCA前(运动试验前)、PTCA后平均11天(早期运动试验)以及PTCA后平均3.2个月(晚期运动试验)进行跑步机运动试验。使用视频密度测定法测量的PTCA后即刻残余狭窄程度在有再狭窄和无再狭窄的两组中相似。在无再狭窄组中,早期运动试验期测量的功能性有氧损伤(FAI)、心肌有氧损伤(MAI)和心率损伤(HRI)与运动试验前期相比有显著改善(分别为p<0.05、p<0.01和p<0.05)。再狭窄组无显著变化。利用PTCA前后的运动参数,对这些组进行判别分析。公式定义如下:Z = 0.0178×(运动试验前的FAI)+0.0543×(早期运动试验的FAI)+0.0513×(运动试验前的MAI)-0.1056×(早期运动试验的MAI)-0.3135。根据该公式,Z值小于0的17例患者中有14例在随访期出现再狭窄。(摘要截断于250字)