Asanoi H, Kuboki M, Yamamoto M, Aizawa T, Fujii J, Takahashi N, Koyama S, Kato K
Cardiovascular Institute, Tokyo, Japan.
J Electrocardiol. 1988 Apr;21(2):147-53. doi: 10.1016/s0022-0736(88)80010-4.
The level of the ST-segment fluctuates transiently during treadmill exercise in some patients with angina pectoris. In the present study, the incidence and clinical significance of ST-segment fluctuation were studied before and after propranolol in 52 patients with angina pectoris. A transient greater than 0.5-mm (0.05 mV) upward shift of the ST-segment during a graded treadmill test was considered a significant fluctuation in leads without signs of previous myocardial infarction. The fluctuation was observed in three of 30 patients with rest or rest and effort angina pectoris before propranolol and in 14 of them after propranolol, while only one of 22 patients with effort angina alone showed fluctuation after the drug. Coronary arteriography revealed that in 15 patients showing ST-segment fluctuation with propranolol, seven patients had no significant coronary stenosis, six had one-vessel disease and two had two-vessel disease. In 24 patients with documented coronary artery spasm, ST-segment fluctuation was induced in two (8%) before propranolol and in 13 (54%) after propranolol. Our results suggest that ST-segment fluctuation during graded treadmill exercise may be related to transient coronary vasospasms exacerbated by propranolol.
在一些心绞痛患者中，ST段水平在跑步机运动期间会短暂波动。在本研究中，对52例心绞痛患者在服用普萘洛尔前后的ST段波动发生率及临床意义进行了研究。在分级跑步机试验期间，ST段出现大于0.5毫米（0.05毫伏）的短暂向上移位被认为是在无既往心肌梗死迹象导联中的显著波动。在30例静息或静息加劳力性心绞痛患者中，3例在服用普萘洛尔前观察到波动，14例在服用普萘洛尔后观察到波动，而在仅22例劳力性心绞痛患者中，只有1例在用药后出现波动。冠状动脉造影显示，在15例服用普萘洛尔后出现ST段波动的患者中，7例无明显冠状动脉狭窄，6例为单支血管病变，2例为双支血管病变。在24例记录有冠状动脉痉挛的患者中，2例（8%）在服用普萘洛尔前诱发了ST段波动，13例（54%）在服用普萘洛尔后诱发了ST段波动。我们的结果表明，分级跑步机运动期间的ST段波动可能与普萘洛尔加剧的短暂冠状动脉痉挛有关。
