Völker K, Hoppe B, Krestin M, Rost R
Institut für Kreislaufforschung und Sportmedizin, Deutsche Sporthochschule Köln.
Fortschr Med. 1990 May 10;108(14):273-5.
The appearance of ST segment depression in the exercise ECG serves as a threshold criterion when it comes to determining the "loadability" of myocardial infarction patients carrying out sports activities. In 27 MI patients, the question was investigated as to the extent to which abnormalities taking the form of silent ischemic episodes could be found during cross-country skiing on plains or during downhill skiing at an altitude of 800 to 2,000 meters. Such silent ischemic attacks were found in 20 out of the 27 patients. Both the duration and incidence were higher during sports activities than during normal day-to-day activities. The heart rate at the time of the appearance of the ischemic episodes was lower in the 12-hour ECG than during ergometry. During sports activities, however, the heart rates were frequently higher than the given training pulse rates. Treatment with nitrates (Isoket retard 120 mg) reduced the incidence and duration of silent ischemias. On account of the spontaneous variability of the parameter, it needs to be interpreted with caution. The incidence of silent ischemic episodes during sports activities in patients with clinical anomalies should prompt a rigorous treatment with drugs, and careful supervision of training.
运动心电图中ST段压低的出现是判定心肌梗死患者进行体育活动时“负荷能力”的一项阈值标准。在27例心肌梗死患者中，研究了在平原越野滑雪或海拔800至2000米的下坡滑雪过程中，以无症状缺血发作形式出现的异常情况的程度。27例患者中有20例出现了这种无症状缺血发作。与正常日常活动相比，体育活动期间无症状缺血发作的持续时间和发生率更高。12小时心电图显示，缺血发作时的心率低于运动试验时的心率。然而，在体育活动期间，心率经常高于给定的训练脉搏率。硝酸盐（长效异乐定120毫克）治疗可降低无症状缺血的发生率和持续时间。由于该参数存在自发变异性，因此需要谨慎解释。临床异常患者在体育活动期间无症状缺血发作的发生率应促使进行严格的药物治疗和仔细的训练监督。
