Konishi T, Koyama T, Aoki T, Yada T, Futagami Y, Sekioka K, Nakano T
First Department of Internal Medicine, Mie University School of Medicine, Tsu.
J Cardiol. 1989 Sep;19(3):797-804.
Responses to supine bicycle ergometer exercise were assessed in a study population consisting of 26 patients with dilated cardiomyopathy (DCM) and 23 patients with ischemic cardiomyopathy (ICM). Left ventricular ejection fraction (LVEF) and regional wall motion were analyzed at rest and during supine bicycle ergometer exercise with radionuclide ventriculography. Although the same degree of LVEF between DCM (23 +/- 8%) and ICM (26 +/- 4%) occurred at rest, the left ventricular regional wall motion abnormality was more prominent in DCM. LVEF during the peak exercise stage in DCM was almost unchanged (24 +/- 8%), but in ICM it decreased significantly (22 +/- 5%). Exercise-induced regional wall motion abnormalities were detected in nine patients (35%) in DCM and 13 patients (57%) in ICM. Although patients with DCM are believed to have diffuse hypokinesis of the left ventricle, severe regional wall motion abnormalities (akinesis or dyskinesis) were frequently observed. During the follow-up period of up to six years, eight patients with DCM died of congestive heart failure. In eight patients with DCM who showed decreased LVEF during exercise, five patients died. However, only three of 18 patients without decreased LVEF during exercise died. Exercise-induced left ventricular dysfunction in DCM seems to be a poor prognostic sign.
在一项研究中，对26例扩张型心肌病（DCM）患者和23例缺血性心肌病（ICM）患者组成的研究人群进行了仰卧位自行车测力计运动反应评估。通过放射性核素心室造影术，在静息状态和仰卧位自行车测力计运动期间分析左心室射血分数（LVEF）和局部室壁运动。尽管静息时DCM组（23±8%）和ICM组（26±4%）的LVEF程度相同，但DCM组左心室局部室壁运动异常更为突出。DCM组运动高峰期的LVEF几乎未变（24±8%），而ICM组则显著下降（22±5%）。DCM组9例患者（35%）和ICM组13例患者（57%）检测到运动诱发的局部室壁运动异常。尽管认为DCM患者存在左心室弥漫性运动减弱，但仍频繁观察到严重的局部室壁运动异常（运动不能或运动障碍）。在长达六年的随访期内，8例DCM患者死于充血性心力衰竭。在8例运动期间LVEF下降的DCM患者中，5例死亡。然而，运动期间LVEF未下降的18例患者中只有3例死亡。DCM患者运动诱发的左心室功能障碍似乎是预后不良的标志。
