Picano E, Masini M, Lattanzi F, Klassen G A, Distante A, Levantesi D, Marraccini P, L'Abbate A
Clinical Physiology Institute, University of Pisa, Italy.
Br Heart J. 1988 Oct;60(4):281-6. doi: 10.1136/hrt.60.4.281.
The short term reproducibility of exercise testing in 25 patients who had exercise induced ST segment elevation without baseline regional asynergy or a previous myocardial infarction, who had different responses to the dipyridamole test, was assessed. The patients performed a dipyridamole echocardiography test and a second exercise stress test. All underwent coronary arteriography. Seventeen patients had transient regional asynergy after dipyridamole (group 1) and either ST segment elevation (14 patients) or depression (three patients); a second group of eight had no asynergy and no electrocardiographic changes (group 2). The repeated exercise stress test was positive in 16 of the 17 patients of group 1 (11 with ST elevation and five with ST depression) and in two patients of group 2 (both had ST depression and one had coronary artery disease). The dipyridamole echocardiography test was positive in 17 of the 19 patients with coronary artery disease and was negative in all six patients without coronary artery disease. The repeated exercise stress test was positive in 17 of the 19 patients with coronary artery disease and in one patient without. The dipyridamole echocardiography test and a repeated exercise stress test, but not a single exercise stress test, identified coronary artery disease causing exercise induced ST segment elevation.
对25例运动诱发ST段抬高但无基线节段性运动失调或既往心肌梗死病史、对双嘧达莫试验有不同反应的患者，评估运动试验的短期可重复性。患者接受了双嘧达莫超声心动图试验和第二次运动负荷试验。所有患者均接受了冠状动脉造影。17例患者在双嘧达莫试验后出现短暂节段性运动失调（第1组），伴有ST段抬高（14例）或压低（3例）；另一组8例无运动失调且无心电图改变（第2组）。在第1组的17例患者中，16例（11例ST段抬高，5例ST段压低）的重复运动负荷试验呈阳性，第2组2例（均为ST段压低，1例有冠状动脉疾病）也呈阳性。19例冠状动脉疾病患者中，17例双嘧达莫超声心动图试验呈阳性，6例无冠状动脉疾病患者均为阴性。19例冠状动脉疾病患者中，17例重复运动负荷试验呈阳性，1例无冠状动脉疾病患者也呈阳性。双嘧达莫超声心动图试验和重复运动负荷试验，而非单次运动负荷试验，可识别出导致运动诱发ST段抬高的冠状动脉疾病。
