Cohn P F, Brown E J, Swinford R, Atkins H L
Am J Cardiol. 1986 Mar 1;57(8):521-6. doi: 10.1016/0002-9149(86)90828-3.
The effect of beta-adrenergic blockade on regional left ventricular wall motion abnormalities was studied in 11 patients with coronary artery disease and silent myocardial ischemia during exercise testing. Four patients were asymptomatic; 7 were asymptomatic after a myocardial infarction. Left ventricular wall motion abnormalities were characterized by reduced regional ejection fraction (EF) during exercise determined by gated left anterior oblique images of the cardiac blood pool. In the 11 patients, 10 anteroseptal and 8 inferoposterior regions were subserved by stenotic coronary arteries. Before beta blockade, regional EF decreased in 15 of 18 regions. After beta blockade, this occurred in only 6 of 18 regions (p less than 0.05); the other 12 regions showed no change or an actual increase in regional EF. Thus, beta-adrenergic blockade effectively improved the reduction in exercise regional EF usually seen in patients with coronary artery disease with silent myocardial ischemia. One probable mechanism of action is a reduction in myocardial oxygen requirement at peak exercise.
在11例冠心病且运动试验时有静息性心肌缺血的患者中，研究了β - 肾上腺素能阻滞剂对局部左心室壁运动异常的影响。4例患者无症状；7例在心肌梗死后无症状。左心室壁运动异常的特征是通过心脏血池门控左前斜位图像测定运动时局部射血分数（EF）降低。在这11例患者中，10个前间隔区域和8个下后壁区域由狭窄的冠状动脉供血。在β受体阻滞剂治疗前，18个区域中的15个区域局部EF降低。β受体阻滞剂治疗后，18个区域中只有6个区域出现这种情况（p<0.05）；其他12个区域局部EF无变化或实际增加。因此，β - 肾上腺素能阻滞剂有效地改善了冠心病合并静息性心肌缺血患者运动时通常出现的局部EF降低。一种可能的作用机制是运动高峰时心肌需氧量的减少。
