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[在正常人和心肌梗死患者中,使用漂浮导管在动态和等长(握力)应激状态下评估左心室功能]

[Left ventricular function assessment using a floating catheter in dynamic and isometric (handgrip) stress in normal and heart infarct patients].

作者信息

Valdivieso E, Busch M, Plänker E, Blümchen G

出版信息

Z Kardiol. 1987 Apr;76(4):239-46.

PMID:3604376
Abstract

UNLABELLED

Left ventricular function was examined in a control group of 8 healthy men (average age 26 +/- 6.2 years) and was compared to 40 post-MI patients (average age 50 +/- 8.2 years, 39 men, one woman). It was measured using the floating-catheter technique under isometric exercise (50% of maximal voluntary contraction using both hands) and also under dynamic exercise (progressive supine bicycle-ergometry). In the control group, there was a significant increase in heart rate, arterial blood-pressure and the average PCP from rest to isometric exercises. PCP was noted to stay within its normal range (less than 20 mm Hg) under both modes of exercise. There was no significant difference comparing the effects of dynamic and isometric exercise (isometric: PCP 13.3 +/- 3.3 mm Hg; dynamic: PCP 11.8 +/- 3.6 mm Hg). In Group I (20 post-MI-patients showing ischemia during exercise-ECG) PCP stayed normal under isometric exercise (PCP 18.8 +/- 10.2 mm Hg). Under dynamic exercise, their PCP increased up to a pathological level (PCP 24.9 +/- 10.1 mm Hg, p less than 0.01). In Group II (20 post-MI-patients with lacking proof of ischemia during exercise-ECG) there was no significant difference between the increase in PCP under isometric vs dynamic exercise (isometric: PCP 18.7 +/- 13.4 mm Hg; dynamic: PCP 18.5 +/- 10.0 mm Hg).

CONCLUSION

The results lead to the conclusion that isometric exercise alone (50% of maximal voluntary contraction using both hands, handgrip) can replace dynamic exercise in the diagnosis of LV malfunction in post-MI patients who do not show ischemia during exercise-ECG.

摘要

未标注

对8名健康男性(平均年龄26±6.2岁)的对照组进行左心室功能检查,并与40名心肌梗死后患者(平均年龄50±8.2岁,39名男性,1名女性)进行比较。在等长运动(双手使用最大自主收缩力的50%)和动态运动(渐进性仰卧位自行车测力计运动)下,使用漂浮导管技术进行测量。在对照组中,从静息状态到等长运动时,心率、动脉血压和平均肺毛细血管楔压(PCP)显著升高。在两种运动模式下,PCP均保持在正常范围内(小于20 mmHg)。比较动态运动和等长运动的效果,无显著差异(等长运动:PCP 13.3±3.3 mmHg;动态运动:PCP 11.8±3.6 mmHg)。在第一组(20名运动心电图显示缺血的心肌梗死后患者)中,等长运动时PCP保持正常(PCP 18.8±10.2 mmHg)。在动态运动时,他们的PCP升高到病理水平(PCP 24.9±10.1 mmHg,p<0.01)。在第二组(20名运动心电图未显示缺血证据的心肌梗死后患者)中,等长运动和动态运动时PCP升高之间无显著差异(等长运动:PCP 18.7±13.4 mmHg;动态运动:PCP 18.5±10.0 mmHg)。

结论

结果表明,对于运动心电图未显示缺血的心肌梗死后患者,仅等长运动(双手使用最大自主收缩力的50%,握力)可替代动态运动用于诊断左心室功能障碍。

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