Rossi L, Variola A, Salvatore C, Carbonieri E, Fogato M, Tomei R, Vassanelli C, Menegatti G, Morando G, Zardini P
Cardiologia. 1989 Mar;34(3):209-15.
In 35 patients with effort angina exercise tests before and after coronary angioplasty (PTCA) were compared, aimed at evaluating functional improvement and at correlating some ergometric parameters with angiographic results. All tests were performed during therapy with verapamil 360 mg/die. After PTCA mean diameter of the stenosis was reduced from 68 +/- 11% to 19 +/- 12%. Duration of exercise and rate-pressure product (RPP) were significantly greater in the test after PTCA. While all tests before PTCA were positive, after PTCA ST segment depression occurred in 9 patients (26%). In 7 of these patients it was less than 1 mm. In 26 patients (74%) tests were negative after PTCA. In patients with ST segment depression, ischemia threshold significantly rose from 5.2 +/- 1.5 min (RPP 15,875 +/- 3,253 to 7.6 +/- 1.2 min (RPP 20,157 +/- 3143). Maximal ST segment depression and ST/HR slope were significantly reduced. In negative stress tests the time free from ischemia significantly rose from 6.5 +/- 2.6 min (RPP 18,872 +/- 3,861) to 10.5 +/- 2.3 min (RPP 28,476 +/- 4,289). In patients with positive tests stenosis after PTCA was more severe than in patients without ST segment depression (29 +/- 13% vs 17 +/- 13%). In patients with ST segment depression improvement of ischemia threshold and of stenosis were correlated. In these patients improvement of ischemia threshold is the ergometric parameter more useful to evaluate the angiographic result of PTCA.
对35例劳力性心绞痛患者在冠状动脉成形术(PTCA)前后进行运动试验比较,旨在评估功能改善情况,并将一些运动耐力参数与血管造影结果相关联。所有试验均在维拉帕米360mg/日治疗期间进行。PTCA后狭窄的平均直径从68±11%降至19±12%。PTCA后的运动试验中运动持续时间和心率血压乘积(RPP)显著增加。PTCA前所有试验均为阳性,PTCA后9例患者(26%)出现ST段压低。其中7例患者压低小于1mm。26例患者(74%)PTCA后试验为阴性。ST段压低的患者中,缺血阈值从5.2±1.5分钟(RPP 15875±3253)显著升至7.6±1.2分钟(RPP 20157±3143)。最大ST段压低和ST/HR斜率显著降低。阴性应激试验中无缺血时间从6.5±2.6分钟(RPP 18872±3861)显著升至10.5±2.3分钟(RPP 28476±4289)。试验阳性的患者PTCA后的狭窄比无ST段压低的患者更严重(29±13%对17±13%)。ST段压低的患者中,缺血阈值改善与狭窄改善相关。在这些患者中,缺血阈值改善是评估PTCA血管造影结果更有用的运动耐力参数。