Scardi S, Borgioni L, Cesanelli R, Pandullo C, Bovenzi M, Negro C
Centro Cardiovascolare, Ospedale Maggiore, Trieste.
G Ital Cardiol. 1990 Apr;20(4):329-36.
We evaluated the repeatability of some measurements taken during the bicycle ergometer exercise test (exercise duration, heart rate and pressure rate product at angina and ST segment depression times) in 166 consecutive non-selected ambulatory patients with proven ischemic heart disease. One hundred and sixty-six patients with history of angina and/or myocardial infarction performed three exercise tests within seven days of wash-out. Eighty-six (58.1%) of these experienced angina and ischemic ST segment depression during all three tests (group 1), and 80 (48.2%) finished at least one test without angina or ST segment depression (group 2). The degree of angina (according to Canadian Cardiovascular Society classification) was higher in the first group than in the second one; on the contrary, exercise duration as well as pressure rate product at ischemic threshold, heart rate and pressure rate product at the onset of angina were significantly lower (0.001 less than p less than 0.05) in the former group. In group 1, we analyzed ergometric parameter measurement "repeatability" during the three consecutive exercise tests. The analysis of variance for repeated measurements showed that exercise duration and pressure rate product values at ischemic threshold did not vary significantly in the three tests, while other ergometric parameters showed a greater variability (0.001 less than p less than 0.05). Age, previous myocardial infarction or rest angina, the number of critically stenotic coronary vessels and the ejection fraction did not condition the repeatability of the test. In conclusion, in our population of non-selected ischemic patients only 52% developed angina and ischemic ST segment depression during all three exercise tests performed.(ABSTRACT TRUNCATED AT 250 WORDS)
我们评估了166例未经挑选的门诊确诊缺血性心脏病患者在自行车测力计运动试验期间进行的一些测量(运动持续时间、心绞痛发作时及ST段压低时的心率和压力心率乘积)的可重复性。166例有胸痛和/或心肌梗死病史的患者在洗脱期7天内进行了三次运动试验。其中86例(58.1%)在所有三次试验中均出现心绞痛和缺血性ST段压低(第1组),80例(48.2%)至少完成一次试验时无心绞痛或ST段压低(第2组)。第1组的心绞痛程度(根据加拿大心血管学会分类)高于第2组;相反,前一组的运动持续时间以及缺血阈值时的压力心率乘积、心绞痛发作时的心率和压力心率乘积显著更低(0.001<p<0.05)。在第1组中,我们分析了连续三次运动试验期间测力计参数测量的“可重复性”。重复测量的方差分析表明,缺血阈值时的运动持续时间和压力心率乘积值在三次试验中无显著变化,而其他测力计参数显示出更大的变异性(0.001<p<0.05)。年龄、既往心肌梗死或静息性心绞痛、严重狭窄冠状动脉血管数量及射血分数均不影响试验的可重复性。总之,在我们这群未经挑选的缺血性患者中,只有52%在所有三次运动试验中均出现心绞痛和缺血性ST段压低。(摘要截断于250字)