Brugger P
Rehabilitationszentrum für rheumatische Erkrankungen, Ludwig Boltzmann-Institut für Rehabilitation interner Erkrankungen, Saalfelden.
Wien Klin Wochenschr. 1987 Oct 23;99(20):716-20.
In 12 patients with silent myocardial ischemia (fall of the ejection fraction (EF) greater than or equal to 5%, without angina pectoris) and in 15 symptomatic patients with coronary heart disease (fall of the EF during exercise EF greater than or equal to 5%, with angina pectoris), the left ventricular ejection fraction and the diastolic function (Peak Filling Rate, PFR; Time to Peak Filling Rate, TPFR) were evaluated before coronary artery bypass surgery and afterwards by the aid of the Nuclear Stethoscope. Our results showed a slight insignificant improvement in the EF from 60 +/- 8.3 per cent at rest to 66 +/- 7.9 per cent vs. 57 +/- 12 per cent to 62.6 +/- 9 per cent in patients with silent ischemia and in patients with angina pectoris after surgery. In contrast to this the EF increased significantly during exercise both in patients with silent ischemia from 52.0 +/- 15.2 per cent to 70.1 +/- 7.9 per cent and in symptomatic patients after revascularisation from, 49 +/- 11.7 per cent on to 64.2 +/- 8.4 per cent (both p less than 0.0001). There was also a similar significant improvement in the diastolic function, whereby the PFR was enhanced from 2.52 +/- 0.54 EDV/sec to 3.31 +/- 0.87 EDV/sec (p less than 0.02) in patients with silent myocardial ischemia and from 2.55 +/- 0.86 EDV/sec to 3.40 +/- 0.98 EDV/sec (p less than 0.02) in symptomatic patients. The TPFR showed a similar improvement.
在12例无症状心肌缺血患者(射血分数(EF)下降大于或等于5%,无心绞痛)和15例有症状的冠心病患者(运动时EF下降大于或等于5%,有心绞痛)中,在冠状动脉搭桥手术前及术后借助核听诊器评估左心室射血分数和舒张功能(峰值充盈率,PFR;达到峰值充盈率的时间,TPFR)。我们的结果显示,无症状缺血患者术后EF从静息时的60±8.3%轻微但无显著改善至66±7.9%,而有症状患者术后EF从57±12%改善至62.6±9%。与此形成对比的是,无症状缺血患者运动时EF显著增加,从52.0±15.2%增至70.1±7.9%,有症状患者血运重建后运动时EF从49±11.7%增至64.2±8.4%(两者p均小于0.0001)。舒张功能也有类似的显著改善,无症状心肌缺血患者的PFR从2.52±0.54 EDV/秒增至3.31±0.87 EDV/秒(p小于0.02),有症状患者的PFR从2.55±0.86 EDV/秒增至3.40±0.98 EDV/秒(p小于0.02)。TPFR也有类似改善。