Tedoriya T, Kawasuji M, Sawa S, Sakakibara N, Iwa T, Taki J
Department of Surgery (1), Kanazawa University School of Medicine.
Kyobu Geka. 1991 Sep;44(10):820-4.
The sequential change of left ventricular function during exercise and recovery after exercise was assessed in 50 patients who had undergone coronary bypass surgery before and after the operation by means of continuous ventricular function monitoring system (VEST). Cardiac response was divided into 4 types with respect to the profiles of the left ventricular ejection fraction during exercise. Type A continued to increase; type B initially increased but decreased in severe exercise stages; type C did not change during exercise; type D continued to decrease. Most patients showed type C or D before surgery but showed type A after surgery. 9 patients with occluded grafts or ungrafted coronary arteries showed type B, C or D. Two patients with extended infarction and poor left ventricular function showed type C after surgery. In recovery period after exercise, the ejection fraction showed an overshoot. The mean ratio of peak ejection fraction during recovery to ejection fraction at rest increased from +62 +/- 12% before operation to +68 +/- 16% after operation (p less than 0.05). The recovery time after exercise was decreased from 195 sec before operation to 98 sec after operation (p less than 0.01). VEST revealed response of left ventricular function during exercise and recovery after exercise as far as detail abnormalities.
通过连续心室功能监测系统（VEST）对50例接受冠状动脉搭桥手术的患者在手术前后运动及运动恢复过程中左心室功能的连续变化进行了评估。根据运动期间左心室射血分数的变化情况，心脏反应分为4种类型。A型持续增加；B型最初增加，但在剧烈运动阶段下降；C型在运动期间无变化；D型持续下降。大多数患者术前表现为C型或D型，但术后表现为A型。9例移植血管闭塞或未移植冠状动脉的患者表现为B型、C型或D型。2例梗死范围扩大且左心室功能较差的患者术后表现为C型。在运动后的恢复期，射血分数出现超射。恢复期间射血分数峰值与静息射血分数的平均比值从术前的+62±12%增加到术后的+68±16%（p<0.05）。运动后的恢复时间从术前的195秒缩短至术后的98秒（p<0.01）。VEST揭示了运动及运动后恢复过程中左心室功能的反应，包括详细的异常情况。
