Iskandrian A S, Heo J
Likoff Cardiovascular Institute, Hahnemann University and Hospital, Philadelphia, Pennsylvania.
Int J Cardiol. 1988 Feb;18(2):207-21. doi: 10.1016/0167-5273(88)90166-0.
This study examines the left ventricular function (by first-pass radionuclide angiography with a multicrystal gamma camera) at rest and during symptom-limited upright exercise in 27 normal subjects (group 1), 25 normotensive subjects with exaggerated systolic blood pressure response to exercise (greater than 200 mm Hg) (group 2) and 25 patients with essential hypertension and no associated coronary artery disease (group 3). There were no significant differences between groups 1 and 2 in exercise tolerance, heart rate, total vascular resistance, left ventricular ejection fraction and end-systolic volume. However, the exercise cardiac index and systolic blood pressure were significantly higher in group 2 (P less than 0.02). Compared to group 3, the subjects in group 2 had higher exercise heart rate (P less than 0.0001), cardiac index (P less than 0.0001), systolic blood pressure (P less than 0.0001) and left ventricular ejection fraction (P less than 0.0001) and lower exercise total vascular resistance (P less than 0.0002) and end-systolic volume (P less than 0.01). Thus, the hemodynamic profile in subjects with exaggerated systolic blood pressure response to exercise differs from that of essential hypertension; it may represent a supernormal response.
本研究通过使用多晶体γ相机的首次通过放射性核素血管造影术，对27名正常受试者（第1组）、25名运动时收缩压反应过度（大于200 mmHg）的血压正常受试者（第2组）以及25名原发性高血压且无相关冠状动脉疾病的患者（第3组）在静息状态和症状限制下的直立运动期间的左心室功能进行了检查。第1组和第2组在运动耐量、心率、总血管阻力、左心室射血分数和收缩末期容积方面无显著差异。然而，第2组的运动心脏指数和收缩压显著更高（P小于0.02）。与第3组相比，第2组的受试者运动心率更高（P小于0.0001）、心脏指数更高（P小于0.0001）、收缩压更高（P小于0.0001）、左心室射血分数更高（P小于0.0001），而运动总血管阻力更低（P小于0.0002）且收缩末期容积更低（P小于0.01）。因此，运动时收缩压反应过度的受试者的血流动力学特征与原发性高血压患者不同；它可能代表一种超常反应。
