Di Pasquale G, Andreoli A, Pinelli G, Grazi P, Manini G, Tognetti F, Testa C
Stroke. 1986 Nov-Dec;17(6):1098-101. doi: 10.1161/01.str.17.6.1098.
A prospective cardiologic evaluation was performed in 83 consecutive patients with transient cerebral ischemia or mild stroke and without symptoms or electrocardiographic signs of ischemic heart disease. Patients were studied with an electrocardiographic exercise test; a positive test was followed by exercise Thallium-201 myocardial scintigraphy. Results were compared to those obtained in a group of 83 age and sex-matched healthy subjects submitted to the same study protocol. Asymptomatic coronary artery disease was detected in 28% of cerebrovascular patients with adequate electrocardiographic exercise test. A scintigraphic perfusion defect of variable extension was found in 19 of them. In the control group the electrocardiographic exercise test was positive in only 6% (p less than 0.01). Our results support the concept that: asymptomatic ischemic heart disease is often associated with cerebrovascular disease; therefore cerebral ischemic attacks may be a marker of coronary artery disease, an active investigation of the heart should be considered in cerebrovascular patients in order to plan optimal, comprehensive management.
对83例连续的短暂性脑缺血或轻度卒中患者进行了前瞻性心脏评估，这些患者无缺血性心脏病症状或心电图体征。对患者进行了心电图运动试验；试验阳性后进行运动铊-201心肌闪烁显像。将结果与一组83例年龄和性别匹配、接受相同研究方案的健康受试者的结果进行比较。在心电图运动试验结果合适的脑血管病患者中，28%检测出无症状性冠状动脉疾病。其中19例发现有不同程度的闪烁显像灌注缺损。在对照组中，心电图运动试验阳性率仅为6%（P<0.01）。我们的结果支持以下观点：无症状性缺血性心脏病常与脑血管病相关；因此，脑缺血发作可能是冠状动脉疾病的一个标志，为了制定最佳的综合治疗方案，应考虑对脑血管病患者进行积极的心脏检查。
