Spinelli L, Cinquegrana G, Spadafora M, Quattrin S, Talarico G, Ferro G
I Clinica Medica, II Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli.
G Ital Cardiol. 1988 Oct;18(10):828-34.
The present work was performed in order to assess the differences in electrocardiographic and hemodynamic responses to supine and upright dynamic exercise of patients with coronary artery disease. Changes in heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure, rate-pressure product (RPP) and ST segment depression during supine and upright bicycle stress test were compared in twenty patients suffering from stable effort angina and without previous myocardial infarction. In the supine posture lower values of HR were observed at rest, during stress test and during three minutes of the recovery period. Conversely, in all patients both SBP and DBP were higher during the stress test in the supine position decubitus. No significant changes in RPP was observed between the two different postures. Finally, ST segment didn't show differences at rest between the upright and supine position. All the patients had a lower ischemic threshold during exercise in the supine position than in the upright one. In fact an ST segment depression greater than 1 mm was observed during stress test in the supine position at lower work-load levels and at lesser HR values. Consequently for given HR, SBP and DBP ST segment, depression was greater in the supine rather than in the upright position.
开展本研究是为了评估冠心病患者仰卧位和直立位动态运动时心电图及血流动力学反应的差异。比较了20例患有稳定劳力性心绞痛且既往无心肌梗死的患者在仰卧位和直立位自行车负荷试验期间心率（HR）、收缩压（SBP）、舒张压（DBP）、心率血压乘积（RPP）及ST段压低的变化。在仰卧位时，静息、负荷试验期间及恢复3分钟时HR值较低。相反，所有患者在仰卧位负荷试验期间SBP和DBP均较高。两种不同体位之间RPP未观察到显著变化。最后，直立位和仰卧位静息时ST段无差异。所有患者仰卧位运动时的缺血阈值均低于直立位。事实上，在仰卧位负荷试验中，在较低工作负荷水平和较低HR值时观察到ST段压低大于1mm。因此，对于给定的HR、SBP和DBP，仰卧位ST段压低大于直立位。
