Mandysová E, Niederle P, Málková A
Ustav fyziologických regulací Ceskoslovenské akademie vĕd, Praha.
Cas Lek Cesk. 1991 Dec 13;130(24-25):692-5.
Syndrome "X" comprises a heterogeneous group of patients with normal coronarographic findings whose repeatedly occurring chest pain is of ischaemic origin, similarly as angina pectoris in patients with CHD. One of the signs of ischaemic etiology of pain in these patients is significant depression of the ST interval on the ECG during ergometry. We were interested to know whether the depression of the ST interval and angina pectoris which develop during a load are associated also with a transient disorder of left ventricular local kinetics. We examined therefore five patients, using the dipyridamol test combined with an isometric load evaluated by two-dimensional (2D) echocardiography. All examinations revealed a normal coronarographic finding and significant electrocardiographic manifestations of ischaemia during ECG stress test. The investigation showed that none of the patients with "X" syndrome suffered from transient changes in the local kinetics of the heart muscle and we assume therefore that myocardial ischaemia in syndrome "X" does not affect a sufficiently large portion of the cardiac wall in the transmural section to be manifested by impaired kinetics detectable by 2D-echocardiography.
“X综合征”包括一组冠状动脉造影结果正常但反复出现胸痛且胸痛起源于缺血的异质性患者，这与冠心病患者的心绞痛类似。这些患者疼痛的缺血性病因的迹象之一是运动试验期间心电图上ST段明显压低。我们想了解负荷期间出现的ST段压低和心绞痛是否也与左心室局部动力学的短暂紊乱有关。因此，我们使用双嘧达莫试验结合二维（2D）超声心动图评估的等长负荷对五名患者进行了检查。所有检查均显示冠状动脉造影结果正常，且心电图负荷试验期间有明显的缺血性心电图表现。研究表明，“X综合征”患者均未出现心肌局部动力学的短暂变化，因此我们认为“X综合征”中的心肌缺血并未影响透壁切片中心脏壁足够大的部分，以至于无法通过二维超声心动图检测到动力学受损。
