Di Pasquale G, Pinelli G, Grazi P, Andreoli A, Corbelli C, Manini G L, Urbinati S, Carini G C
Division of Cardiology, Bellaria Hospital, Bologna, Italy.
Eur Heart J. 1988 Dec;9 Suppl N:104-7. doi: 10.1093/eurheartj/9.suppl_n.104.
In order to assess the incidence of silent myocardial ischaemia, 190 consecutive patients with cerebral ischaemia and without symptoms or electrocardiographic signs of ischaemic heart disease, underwent a maximal exercise treadmill test. Patients with a positive exercise test were submitted to exercise thallium myocardial scintigraphy. Results were compared with those obtained in a control group of 113 healthy subjects submitted to the same study protocol. An adequate exercise test was obtained in 140 patients with cerebral ischaemia. The exercise test was positive in 36 cases (26%). The end points were exhaustion in 24 patients, ST segment depression greater than or equal to 3 mm in seven and systolic blood pressure greater than or equal to 240 mmHg in five. The exercise thallium myocardial scintigraphy was normal in three and abnormal in 33: reversible perfusion defects were detected in 26 cases and fixed defects in seven. In the control group, matched for age and sex, the exercise test was positive in only seven cases (6%; P less than 0.01); the exercise myocardial scintigraphy was normal in five and abnormal in two subjects. In conclusion, in a remarkable proportion of middle-aged patients with cerebral ischaemia, silent myocardial ischaemia can be detected by means of noninvasive cardiologic investigations.
为评估无症状心肌缺血的发生率，190例连续性脑缺血患者且无缺血性心脏病症状或心电图表现，接受了极量运动平板试验。运动试验阳性的患者接受运动铊心肌闪烁扫描。将结果与113名接受相同研究方案的健康受试者对照组所得结果进行比较。140例脑缺血患者完成了充分的运动试验。运动试验阳性36例（26%）。终点情况为：24例运动至力竭，7例ST段压低≥3mm，5例收缩压≥240mmHg。运动铊心肌闪烁扫描3例正常，33例异常：26例检测到可逆性灌注缺损，7例为固定缺损。在年龄和性别匹配的对照组中，运动试验仅7例阳性（6%；P<0.01）；运动心肌闪烁扫描5例正常，2例异常。总之，在相当比例的中年脑缺血患者中，通过无创心脏检查可检测到无症状心肌缺血。
