Kubo H, Yano K, Hasegawa N, Okura K, Hase H, Hirai H, Ishida K, Yabuki S, Machii K
Third Department of Internal Medicine, Toho University School of Medicine, Tokyo.
J Cardiol. 1991;21(4):889-97.
The effects of exercise training on myocardial perfusion during the first 3 months after acute myocardial infarction (AMI) were assessed by exercise myocardial scintigraphy and fibrinolytic examinations. Symptom-limited treadmill exercise with thallium-201 myocardial single photon emission CT (SPECT) and fibrinolytic examinations (tissue plasminogen activator antigen: tPA, plasminogen activator inhibitor-1 antigen : PAI-1) were performed 2 and 14 weeks after AMI in 13 patients with exercise training and in 12 patients without exercise training. For quantitative analysis, counts of region of interest in the infarct area and normal reference area were calculated on a polar map obtained from myocardial SPECT. Severity of the hypoperfused myocardium was determined as an initial percent uptake (%IU) and a delayed percent uptake (%DU). The difference (%DU-%IU) was defined as a parameter of residual ischemia in the infarct area (%redistribution : %RD). Total treadmill exercise duration according to the Bruce protocol increased significantly in the training group (351 +/- 89 to 431 +/- 118 sec, p < 0.01); whereas, there was no significant change in the non-training group (340 +/- 95 to 356 +/- 123 sec). In the training group the pressure-rate product and %DU increased significantly (225 +/- 55 to 259 +/- 58 mmHg.beats/min x 100, 59 +/- 19 to 65 +/- 20%, p < 0.01, respectively), and %RD decreased significantly (8.8 +/- 6.7 to 4.8 +/- 4.5%, p < 0.01), but there was no significant change in the non-training group (231 +/- 89 to 240 +/- 86 mmHg.beats/min x 100, 56 +/- 17 to 57 +/- 12% and 7.4 +/- 5.5 to 6.2 +/- 6.5%, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
通过运动心肌闪烁扫描和纤溶检查评估急性心肌梗死（AMI）后前3个月运动训练对心肌灌注的影响。对13例接受运动训练的患者和12例未接受运动训练的患者在AMI后2周和14周进行了症状限制性平板运动试验，同时进行铊-201心肌单光子发射计算机断层扫描（SPECT）和纤溶检查（组织型纤溶酶原激活物抗原：tPA，纤溶酶原激活物抑制剂-1抗原：PAI-1）。为进行定量分析，在从心肌SPECT获得的极坐标图上计算梗死区域和正常对照区域的感兴趣区计数。将心肌灌注不足的严重程度确定为初始摄取百分比（%IU）和延迟摄取百分比（%DU）。差异（%DU-%IU）被定义为梗死区域残余缺血的参数（%再分布：%RD）。根据布鲁斯方案，训练组的总平板运动持续时间显著增加（351±89至431±118秒，p<0.01）；而未训练组无显著变化（340±95至356±123秒）。训练组的压力-心率乘积和%DU显著增加（225±55至259±58 mmHg·次/分钟×100，59±19至65±20%，p均<0.01），%RD显著降低（8.8±6.7至4.8±4.5%，p<0.01），但未训练组无显著变化（分别为231±89至240±86 mmHg·次/分钟×100，56±17至57±12%和7.4±5.5至6.2±6.5%）。（摘要截断于250字）
