Schwammenthal E, Jehle J, Lauber A, Lösse B, Spiller P, Loogen F
Z Kardiol. 1986 May;75(5):267-76.
24 patients with coronary artery disease underwent intravenous digital subtraction angiocardiography at rest and during exercise before and after percutaneous transluminal coronary angioplasty (PTCA). Before PTCA mean pulmonary artery pressure increased pathologically in 20 patients (on average from 22 +/- 4 to 40 +/- 9 mm Hg, p less than 0.001). The increase in cardiac index from 4.2 +/- 1.3 to 6.2 +/- 2.01 I X min-1 X m-2 (p less than 0.01) was achieved by an increase in heart rate from 77 +/- 13 to 119 +/- 16 min-1 (p less than 0.001) as stroke volume remained unchanged during exercise (52 +/- 14 ml X m-2, resting value: 53 +/- 13 ml X m-2). Though end-systolic volume increased from 32 +/- 11 to 41 +/- 13 ml X m-2 (p less than 0.001) and ejection fraction fell from 63 +/- 8% to 56 +/- 10% (p less than 0.005), stroke volume remained unchanged due to an enhanced diastolic filling (EDVI: 86 +/- 19 ml X m-2 at rest, 92 +/- 18 ml X m-2 during exercise, p less than 0.001). After angiographically successful PTCA in 21 of 24 patients average mean pulmonary artery pressure during exercise remained pathologically elevated (36 +/- 9 mm Hg, no significant difference from value before PTCA). It normalized in only 6 of 17 patients. On the other hand there was a marked improvement of left ventricular systolic performance. Ejection fraction during exercise (65 +/- 11%) was higher than before PTCA (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
24例冠心病患者在经皮腔内冠状动脉成形术（PTCA）前后，于静息和运动状态下接受了静脉数字减影血管造影。PTCA前，20例患者的平均肺动脉压呈病理性升高（平均从22±4 mmHg升至40±9 mmHg，p<0.001）。心率从77±13次/分钟增至119±16次/分钟（p<0.001），心排血量指数从4.2±1.3增至6.2±2.01 I·min⁻¹·m⁻²（p<0.01），而运动期间每搏量保持不变（52±14 ml·m⁻²，静息值：53±13 ml·m⁻²）。虽然收缩末期容积从32±11 ml·m⁻²增至41±13 ml·m⁻²（p<0.001），射血分数从63±8%降至56±10%（p<0.005），但由于舒张期充盈增强（静息时舒张末期容积指数：86±19 ml·m⁻²，运动时92±18 ml·m⁻²，p<0.001），每搏量保持不变。24例患者中有21例血管造影成功完成PTCA后，运动期间平均肺动脉压仍呈病理性升高（36±9 mmHg，与PTCA前的值无显著差异）。仅17例患者中的6例恢复正常。另一方面，左心室收缩功能有显著改善。运动时的射血分数（65±11%）高于PTCA前（p<0.001）。（摘要截选至250字）
