Gavrielides S, Kaski J C, Tousoulis D, Pupita G, Galassi A R, Maseri A
Cardiovascular Research Unit, Royal Postgraduate Medical School, Hammersmith Hospital, London, England.
Am Heart J. 1991 Jun;121(6 Pt 1):1665-70. doi: 10.1016/0002-8703(91)90010-f.
To assess whether the duration of ischemic ST segment depression after exercise can be modified by changes in body position during recovery or with different types of exercise, 18 patients with chronic stable angina, positive exercise test results, and documented coronary artery disease were prospectively studied. Every patient underwent testing with three different exercise protocols: (1) Bruce (Bruce-standing recovery), (2) abrupt onset of exercise (abrupt), and (3) modified Bruce protocol preceded by a 10-minute warm-up period (warm-up). After exercise test patients recovered in a sitting position. In addition, all patients performed a fourth exercise (Bruce protocol), but this time they recovered in the supine position (Bruce-supine recovery). Time and heart rate-blood pressure product at 1 mm ST segment depression were similar for Bruce-standing recovery, abrupt, and Bruce-supine recovery protocols (5.1 +/- 2, 4.4 +/- 2, and 5.2 +/- 2 minutes and 20.8 +/- 4, 21.3 +/- 4, and 20.4 +/- 4 beats/min x mm Hg x 10(-3), respectively. Heart rate and heart rate-blood pressure product at peak exercise did not differ in Bruce-standing recovery, abrupt, and Bruce-supine recovery. Maximal ST segment depression was -2.0, -1.9, and -2.0 mm with Bruce-standing recovery, abrupt, and Bruce-supine recovery exercise, respectively, and -1.5 mm with warm-up exercise (p less than 0.05). Duration of ST segment depression into recovery was significantly prolonged after Bruce-supine recovery exercise (9.4 + 5 minutes) compared with Bruce-standing recovery, abrupt, and warm-up protocols (6.8 + 3, 5.9 + 4, and 5.0 + 3 minutes, respectively; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
为评估运动后缺血性ST段压低的持续时间是否可通过恢复过程中体位的改变或不同类型的运动而改变，对18例慢性稳定型心绞痛、运动试验结果阳性且有冠状动脉疾病记录的患者进行了前瞻性研究。每位患者接受三种不同运动方案的测试：（1）布鲁斯方案（布鲁斯方案-站立恢复），（2）运动突然开始（突然开始），（3）在10分钟热身期后进行的改良布鲁斯方案（热身）。运动试验后患者以坐姿恢复。此外，所有患者都进行了第四次运动（布鲁斯方案），但这次他们以仰卧位恢复（布鲁斯方案-仰卧恢复）。对于布鲁斯方案-站立恢复、突然开始和布鲁斯方案-仰卧恢复方案，ST段压低1 mm时的时间和心率-血压乘积相似（分别为5.1±2、4.4±2和5.2±2分钟以及20.8±4、21.3±4和20.4±4次/分钟×毫米汞柱×10⁻³）。布鲁斯方案-站立恢复、突然开始和布鲁斯方案-仰卧恢复中运动峰值时的心率和心率-血压乘积无差异。布鲁斯方案-站立恢复、突然开始和布鲁斯方案-仰卧恢复运动时最大ST段压低分别为-2.0、-1.9和-2.0 mm，热身运动时为-1.5 mm（p<0.05）。与布鲁斯方案-站立恢复、突然开始和热身方案（分别为6.8±3、5.9±4和5.0±3分钟）相比，布鲁斯方案-仰卧恢复运动后恢复过程中ST段压低的持续时间显著延长（9.4±5分钟；p<0.05）。（摘要截断于250字）
