Kawasuji M, Tedoriya T, Sakakibara N, Sawa S, Takemura H, Iwa T, Taki J
Department of Surgery (I), Kanazawa University School of Medicine, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Aug;39(8):1160-5.
The response of left ventricular function during exercise and recovery after exercise was assessed in 52 patients with coronary artery bypass surgery by means of a radionuclide continuous ventricular function monitor. This system consists of 2 radionuclide detectors, recorder and a computer. After the equilibration of 20 mCi technetium 99m-labeled autologaous red blood cells into the intravascular space, the beat by beat radionuclide data were summed for 20-sec intervals to measure left ventricular ejection fraction (EF). Before surgery, the mean EF decreased with exercise from 51 +/- 9% to 45 +/- 11% (p less than 0.001). Cardiac response was divided into 4 types according to the profiles of the EFs during exercise. In 6 patients, EF continued to increase until maximal exercise (type A). In 10 patients, EF initially increased and then decreased in late exercise stages (type B). In 9 patients, EF did not change significantly during exercise (type C). In 27 patients, EF decreased throughout exercise (type D). After surgery, the mean EF increased with exercise from 53 +/- 10% to 60 +/- 13% (p less than 0.001). Thirty-five patients showed type A, 9 type B, 5 type C, and 3 type D. Two type D and 5 type B patients had occluded grafts or ungrafted coronary arteries. Four patients with complete revascularization including an internal thoracic artery and saphenous vein grafts showed type B. Three patients with extensive infarction and poor left ventricular function showed type C.(ABSTRACT TRUNCATED AT 250 WORDS)
采用放射性核素连续心室功能监测仪,对52例冠状动脉搭桥手术患者运动期间及运动后恢复过程中的左心室功能反应进行了评估。该系统由2个放射性核素探测器、记录仪和一台计算机组成。在将20毫居里锝99m标记的自体红细胞平衡至血管腔内后,以20秒为间隔对逐搏放射性核素数据进行求和,以测量左心室射血分数(EF)。术前,平均EF随运动从51±9%降至45±11%(p<0.001)。根据运动期间EF的变化情况,心脏反应分为4种类型。6例患者,EF持续增加直至最大运动(A型)。10例患者,EF最初增加,然后在运动后期下降(B型)。9例患者,EF在运动期间无显著变化(C型)。27例患者,EF在整个运动过程中下降(D型)。术后,平均EF随运动从53±10%升至60±13%(p<0.001)。35例为A型,9例为B型,5例为C型,3例为D型。2例D型和5例B型患者存在移植血管闭塞或未移植的冠状动脉。4例包括胸廓内动脉和大隐静脉移植的完全血运重建患者为B型。3例广泛梗死且左心室功能差的患者为C型。(摘要截取自250字)