Brown E J, Idoine J, Cohn P F
Cardiol Clin. 1986 Nov;4(4):677-84.
To determine the ability of quantitative radionuclide ventriculography to localize coronary artery stenoses in patients with angina and silent myocardial ischemia, the authors studied changes in regional ejection fractions produced by supine bicycle exercise in 49 patients, 16 of whom had silent myocardial ischemia. For example, in 35 patients with 70 per cent or greater stenoses of the left anterior descending and/or left main coronary artery, anteroseptal regional ejection fraction fell from 55 +/- 3 per cent at rest to 50 +/- 4 per cent with exercise (p less than 0.05). In 14 patients with lesser or no stenoses of the left anterior descending and/or left main coronary artery, anteroseptal regional ejection fraction increased from 62 +/- 4 per cent at rest to 67 +/- 5 per cent during exercise (p less than 0.05). Similar findings were obtained in patients with 70 per cent or greater stenoses of the left circumflex and/or right coronary artery in whom inferoposterior regional ejection fraction was measured and compared with that in patients with lesser or no stenoses in these vessels. Thus, evaluation of regional ejection fraction allowed the localization of coronary artery stenoses in coronary patients whether or not their ischemia was accompanied by pain.
为了确定定量放射性核素心室造影术对心绞痛和无症状心肌缺血患者冠状动脉狭窄的定位能力，作者研究了49例患者仰卧位自行车运动引起的局部射血分数变化，其中16例有无症状心肌缺血。例如，在35例左前降支和/或左主干冠状动脉狭窄达70%或以上的患者中，前间隔局部射血分数从静息时的55±3%降至运动时的50±4%（p<0.05）。在14例左前降支和/或左主干冠状动脉狭窄较轻或无狭窄的患者中，前间隔局部射血分数从静息时的62±4%增加到运动时的67±5%（p<0.05）。在测量了左旋支和/或右冠状动脉狭窄达70%或以上患者的下后壁局部射血分数，并与这些血管狭窄较轻或无狭窄患者的射血分数进行比较时，也获得了类似的结果。因此，对局部射血分数的评估能够对冠心病患者的冠状动脉狭窄进行定位，无论其缺血是否伴有疼痛。
