Wilke N A, Sheldahl L M, Levandoski S G, Hoffman M D, Tristani F E
Cardiac Rehabilitation Center, Zablocki Veterans Administration Medical Center, Milwaukee, Wisconsin 53295.
Am J Cardiol. 1989 Oct 1;64(12):736-40. doi: 10.1016/0002-9149(89)90756-x.
The clinical merits of handgrip and weight carrying tests were compared in 30 patients with documented coronary artery disease. The static loads in the 2 tests were matched by percentage of maximal static effort and corresponded to 25 and 45% of maximal voluntary handgrip contraction and 25 and 45% of maximal 1-hand lift capacity. Each static load in both tests was continued for less than or equal to 3 minutes. At the 25% maximal effort stage, 93 and 90% of patients were able to complete 3 minutes of handgrip and weight carrying, respectively. Only 13 and 10% were able to complete 3 minutes at the 45% maximal effort stage with handgrip and weight carrying, respectively. Arm fatigue and an increase in diastolic blood pressure greater than 120 mm Hg were the predominant endpoints. Weight carrying resulted in significantly higher (p less than 0.05) heart rate, systolic blood pressure, pressure-rate product, ventilation and oxygen consumption compared to handgrip. Diastolic blood pressure responses did not differ between the tests. None of the patients demonstrated ischemic responses to either handgrip or weight carrying and the incidence of arrhythmias was rare. The diastolic blood pressure response to static effort is equally evaluated by handgrip and weight carrying tests. However, the greater myocardial oxygen demand, reflected by the pressure-rate product, in addition to the greater total body oxygen consumption, imposed by weight carrying, enhances the clinical application of the weight carrying test.
在30例有冠状动脉疾病记录的患者中比较了握力试验和负重试验的临床价值。两项试验中的静态负荷以最大静态用力的百分比进行匹配,分别相当于最大自主握力收缩的25%和45%以及单手最大举力的25%和45%。两项试验中的每个静态负荷持续时间均小于或等于3分钟。在25%最大用力阶段,分别有93%和90%的患者能够完成3分钟的握力试验和负重试验。在45%最大用力阶段,分别只有13%和10%的患者能够完成3分钟的握力试验和负重试验。手臂疲劳和舒张压升高超过120 mmHg是主要的终点指标。与握力试验相比,负重试验导致心率、收缩压、压力-心率乘积、通气量和耗氧量显著更高(p<0.05)。两项试验的舒张压反应无差异。所有患者对握力试验或负重试验均未表现出缺血反应,心律失常的发生率很低。握力试验和负重试验对静态用力的舒张压反应评估效果相同。然而,负重试验所带来的压力-心率乘积所反映的更大心肌需氧量,以及更大的全身耗氧量,增强了负重试验的临床应用价值。