Pu M
Ruijin Hospital, Shanghai Second Medical University.
Zhonghua Xin Xue Guan Bing Za Zhi. 1991 Oct;19(5):311-3, 332.
To evaluate the influence of isometric exercise on left ventricular (LV) diastolic function, transmittal flow velocity was measured by pulsed Doppler echocardiography before and after handgrip in 15 normal subjects and the patients with hypertension as well as 18 patients with coronary heart disease (CHD). Statistically significant differences in peak velocity of early rapid filling (Ev), the ratios of peak early to late diastolic velocity (Ev/Av) and early to late velocity-time integral (Ei/Ai) between normal subjects and both the patients with hypertension and CHD were noted at rest. After isometric exercise, significant increase in Av (0.70 +/- 0.13 vs 0.76 +/- 0.14, P less than 0.01) and Ai/total VTi (0.35 +/- 0.07 vs 0.42 +/- 0.08, P less than 0.05) were showed in the hypertension group. In CHD, multiple Doppler parameters changed after isometric exercise with increase in Av (0.70 +/- 0.16 vs 0.85 +/- 0.18, P less than 0.01) and Ai/total VTi (0.36 +/- 0.08 vs 0.42 +/- 0.08, P less than 0.01) as well as decrease in Ev/Av (0.95 +/- 0.22 vs 0.82 +/- 0.15, P less than 0.05) and Ei/Ai (1.64 +/- 0.51 vs 1.35 +/- 0.34, P less than 0.05). However, there was no significant difference in any Doppler indices of LV diastolic function in the present normal subjects after isometric exercise. Thus, isometric exercise further enhanced late LV diastolic filling in the patients with impaired LV diastolic function in resting states greater than normal subjects, and myocardial ischemia induced by handgrip may play partial role in more changes in Doppler indices of LV diastolic function in CHD than the patients with hypertension.
为评估等长运动对左心室（LV）舒张功能的影响，采用脉冲多普勒超声心动图测量了15名正常受试者、高血压患者以及18名冠心病（CHD）患者在握力运动前后的经二尖瓣血流速度。静息时，正常受试者与高血压患者及冠心病患者之间的早期快速充盈峰值速度（Ev）、舒张早期与晚期峰值速度之比（Ev/Av）以及早期与晚期速度时间积分（Ei/Ai）存在统计学显著差异。等长运动后，高血压组的Av（0.70±0.13对0.76±0.14，P＜0.01）和Ai/总VTi（0.35±0.07对0.42±0.08，P＜0.05）显著增加。在冠心病患者中，等长运动后多个多普勒参数发生变化，Av（0.70±0.16对0.85±0.18，P＜0.01）和Ai/总VTi（0.36±0.08对0.42±0.08，P＜0.01）增加，Ev/Av（0.95±0.22对0.82±0.15，P＜0.05）和Ei/Ai（1.64±0.51对1.35±0.34，P＜0.05）降低。然而，等长运动后本研究中的正常受试者左心室舒张功能的任何多普勒指标均无显著差异。因此，等长运动进一步增强了静息状态下左心室舒张功能受损患者的左心室舒张晚期充盈，与高血压患者相比，握力诱发的心肌缺血可能在冠心病患者左心室舒张功能多普勒指标的更多变化中起部分作用。
