Marín Huerta E, Moya Mur J L, de Pablo C, Rayo I, Muela A, Martín de Dios R, Moro C
Servicio de Cardiología, Hospital Ramón y Cajal, Madrid.
Rev Esp Cardiol. 1990 Feb;43(2):72-9.
To evaluate the prognostic significance of silent ischemia during exercise testing, 152 consecutive patients (143 males, 9 females) with a mean SD of 55 +/- 7 years (age range 32-73) who underwent exercise testing and coronary arteriography within 3 months were studied. All patients had the following characteristics: 1) a positive electrocardiographic exercise test response; 2) significant coronary artery disease on the arteriography; 3) uninterrupted clinical follow-up for a minimum of 6 months. The 152 patients were divided in 2 groups: group I: 56 patients (37%) with ischemic ST-segment depression during exercise testing without angina (silent ischemia); group II: 96 patients (63%) with ischemic ST-segment depression and angina (symptomatic ischemia). Patients in group I and group II showed similar time to ST-segment depression (3.6 +/- 1.5 min vs 3.2 +/- 1.4 min; p = NS), maximal ST-segment depression and peak heart rate-systolic pressure product (21,151 +/- 7,124 vs 20,456 +/- 6,024; p = NS). Exercise duration was longer in group I than in group II (5.6 +/- 2.1 min vs 4.8 +/- 1.5 min; p less than 0.001). The extent of coronary artery disease defined by the number of significant narrowed coronary vessels, left ventricular end diastolic pressure and ejection fraction were similar in the 2 groups. Sixty six patients who underwent coronary bypass surgery were not included in the analysis. The remaining 86 patients (40 in group I and 46 in group II) were medically treated. The mean follow-up period was 43,5 +/- 25 months (range 6-101).2+ myocardial ischemia during exercise testing.
为评估运动试验期间无症状性缺血的预后意义，对152例连续患者（143例男性，9例女性）进行了研究，这些患者平均年龄为55±7岁（年龄范围32 - 73岁），在3个月内接受了运动试验和冠状动脉造影。所有患者具有以下特征：1）运动试验心电图反应阳性；2）冠状动脉造影显示严重冠状动脉疾病；3）至少6个月的不间断临床随访。152例患者分为两组：第一组：56例患者（37%）在运动试验期间出现缺血性ST段压低但无胸痛（无症状性缺血）；第二组：96例患者（63%）出现缺血性ST段压低并有胸痛（有症状性缺血）。第一组和第二组患者出现ST段压低的时间相似（3.6±1.5分钟对3.2±1.4分钟；p =无显著性差异），最大ST段压低和心率收缩压峰值乘积相似（21,151±7,124对20,456±6,024；p =无显著性差异）。第一组的运动持续时间长于第二组（5.6±2.1分钟对4.8±1.5分钟；p＜0.001）。两组中由严重狭窄冠状动脉血管数量、左心室舒张末期压力和射血分数所定义的冠状动脉疾病程度相似。66例接受冠状动脉搭桥手术的患者未纳入分析。其余86例患者（第一组40例，第二组46例）接受药物治疗。平均随访期为43.5±25个月（范围6 - 101个月）。运动试验期间2+心肌缺血。
