通过运动诱发型心绞痛患者心肌游离脂肪酸提取早期检测心肌缺血

Early detection of myocardial ischemia by myocardial free fatty acid extraction in patients with exercise-induced angina pectoris.

作者信息

Kamihara S, Yokota M, Iwase M, Miyahara T, Hayashi H, Saito H, Sugiyama S, Ozawa T

机构信息

First Department of Internal Medicine, Nagoya University School of Medicine, Japan.

出版信息

Am J Cardiol. 1989 Jul 15;64(3):180-5. doi: 10.1016/0002-9149(89)90453-0.

DOI:10.1016/0002-9149(89)90453-0

PMID:2741828

Abstract

This study investigated whether the measurement of plasma free fatty acids (FFAs) could assist in the early detection of exercise-induced myocardial ischemia. Fifteen subjects with effort angina pectoris underwent angina-limited supine bicycle ergometer exercise testing. Myocardial FFA extraction decreased significantly from 22.8 +/- 3.1% at rest to 7.7 +/- 1.5% at peak exercise (p less than 0.05). Myocardial lactate extraction showed no significant change between rest and peak exercise. After control exercise testing, 8 subjects were given a single oral dose of nilvadipine (6 mg) and then again underwent exercise testing for the same duration. Nilvadipine lessened or abolished chest pain and there was less depression of the ST segment at peak exercise. Furthermore, myocardial FFA extraction showed no significant change between rest and peak exercise after nilvadipine administration. These results suggest that myocardial FFA extraction can be used to assess the presence of exercise-induced myocardial ischemia at an earlier stage than myocardial lactate extraction.

摘要

本研究调查了血浆游离脂肪酸（FFA）的测量是否有助于运动诱发心肌缺血的早期检测。15例劳力性心绞痛患者进行了心绞痛限制的仰卧位自行车测力计运动试验。心肌FFA摄取从静息时的22.8±3.1%显著下降至运动高峰时的7.7±1.5%（p<0.05）。静息和运动高峰时心肌乳酸摄取无显著变化。在对照运动试验后，8例受试者口服一剂硝苯地平（6mg），然后再次进行相同持续时间的运动试验。硝苯地平减轻或消除了胸痛，运动高峰时ST段压低减少。此外，服用硝苯地平后，静息和运动高峰时心肌FFA摄取无显著变化。这些结果表明，与心肌乳酸摄取相比，心肌FFA摄取可用于更早阶段评估运动诱发心肌缺血的存在。