Ilić S
Acta Med Iugosl. 1989;43(3):205-13.
In the group of 85 patients with coronary artery disease the exercise and 24-hour ambulatory electrocardiograms were recorded in order to analyse the frequency of asymptomatic episodes of myocardial ischemia and to determine differences between symptomatic and asymptomatic episodes of myocardial ischemia. All patients had ischemic ST-segment depression (greater than or equal to 1 mm) on the exercise electrocardiogram. During exercise testing, 23 (27%) patients had ST-segment depression without anginal pain or dyspnea. On the 24-hour ambulatory electrocardiogram transient episodes of myocardial ischemia were found in 50 (58.8%) patients. In 16 patients all episodes were asymptomatic, in 9 all episodes were symptomatic, and in 25 patients some episodes were symptomatic and some asymptomatic. During a 24-hour electrocardiogram in 25 patients with both types of ischemia, 175 transient episodes of myocardial ischemia were recorded. Most of them (125, i.e. 71.4%) were asymptomatic. The heart rate in symptomatic and asymptomatic episodes was similar. The magnitude of ST-segment depression in symptomatic episodes was higher than in asymptomatic episodes (P less than 0.01). There was not significant difference in the duration of the two types of myocardial ischemia. This study suggests: 1. During daily activities, in patients with the positive exercise test, asymptomatic episodes of myocardial ischemia are more frequent than symptomatic episodes. 2. The magnitude of ST-segment depression is the main factor in the determination of the presence of anginal pain.
在85例冠心病患者组中，记录了运动心电图和24小时动态心电图，以分析无症状性心肌缺血发作的频率，并确定有症状和无症状性心肌缺血发作之间的差异。所有患者运动心电图均有缺血性ST段压低（≥1mm）。运动试验期间，23例（27%）患者出现ST段压低但无胸痛或呼吸困难。在24小时动态心电图中，50例（58.8%）患者发现有短暂性心肌缺血发作。16例患者所有发作均无症状，9例所有发作均有症状，25例患者有些发作有症状，有些无症状。在25例两种类型缺血均有的患者进行24小时心电图检查时，记录到175次短暂性心肌缺血发作。其中大多数（125次，即71.4%）无症状。有症状和无症状发作时的心率相似。有症状发作时ST段压低的幅度高于无症状发作（P<0.01）。两种类型心肌缺血的持续时间无显著差异。本研究提示：1. 在日常活动中，运动试验阳性的患者，无症状性心肌缺血发作比有症状发作更频繁。2. ST段压低的幅度是决定是否存在胸痛的主要因素。
