Talwar K K, Narula J, Dev V, Bhatia M L
Department of Cardiology, All India Institute of Medical Sciences, New Delhi.
Int J Cardiol. 1989 Sep;24(3):293-5. doi: 10.1016/0167-5273(89)90007-7.
R wave amplitude changes during exercise have been a controversial issue as both increase and decrease in amplitude have been reported in patients with coronary arterial disease. This variability in response is attributed to change in position and heart axis on exercise. In view of this limitation, this study evaluated the change in spatial R maximum amplitude on exercise, which should not be affected by the above factors. Twenty patients with ischaemic heart disease (male 20, age 38-61 years) and 9 control subjects (male 9, age 32-65 years) were studied. Orthogonal leads, X, Y, Z were recorded using corrected Frank lead system on a stereokinematic vectorcardiograph (Tonnies). The magnitude of spatial R maximum cardiac vector increased from 0.1 to 0.6 mV in 8/9 control subjects and decreased or showed no change in 18 of the 20 patients with coronary arterial disease. In the control group, the mean value at the end of exercise (0.98 +/- 0.34 mV) was significantly less (P less than 0.01) as compared to pre-exercise value (1.09 +/- 0.2 mV). Our preliminary observations thus indicate that, with exercise, the magnitude of spatial R maximum cardiac vector decreases or shows no alteration in height in patients with coronary arterial disease whereas it increases in normal subjects.
运动期间R波振幅的变化一直是一个有争议的问题，因为在冠状动脉疾病患者中，既有振幅增加的报道，也有振幅降低的报道。这种反应的变异性归因于运动时体位和心脏轴的变化。鉴于这一局限性，本研究评估了运动时空间最大R波振幅的变化，该变化不应受上述因素影响。研究了20例缺血性心脏病患者（男性20例，年龄38 - 61岁）和9例对照者（男性9例，年龄32 - 65岁）。使用校正的Frank导联系统在立体运动向量心电图仪（Tonnies）上记录正交导联X、Y、Z。9例对照者中有8例空间最大心脏向量的幅度从0.1 mV增加到0.6 mV，20例冠状动脉疾病患者中有18例下降或无变化。在对照组中，运动结束时的平均值（0.98±0.34 mV）显著低于运动前值（1.09±0.2 mV）（P<0.01）。因此，我们的初步观察表明，运动时，冠状动脉疾病患者空间最大心脏向量的幅度降低或高度无变化，而正常受试者则增加。
