Ouyang P, Shapiro E P, Chandra N C, Gottlieb S H, Chew P H, Gottlieb S O
Am J Cardiol. 1987 Apr 1;59(8):730-4. doi: 10.1016/0002-9149(87)91082-4.
Sixty consecutive patients were studied who had positive responses to Naughton exercise treadmill testing (at least 1.5 mm of ST-segment shift in at least 2 leads or thallium reperfusion abnormalities) with or without symptoms of angina 11 +/- 1 days after acute myocardial infarction (AMI). All patients had undergone coronary angiography 24 +/- 4 days after infarction. Thirty-eight patients (63%) had no treadmill angina (silent ischemia, group I) and 22 patients had typical treadmill angina (symptomatic ischemia, group II). Use of beta-blocking drugs, calcium antagonists and nitrates at the time of exercise testing did not differ in the 2 groups. All 9 patients with diabetes mellitus were in the asymptomatic group (p less than 0.40) and group I had a greater proportion of inferior wall AMI (30 of 38) than group II (11 of 22, p = 0.02). Total exercise treadmill test duration (group I 422 +/- 31 seconds, group II 400 +/- 46 seconds) and rate-pressure product were not different in the 2 groups. The number of patients unable to exercise 5 minutes (12 in group I and 7 in group II), the number with diffuse electrocardiographic changes (9 in group I and 7 in group II), and the number with inadequate blood pressure response (8 in group I and 4 in group II) were also similar. At coronary arteriography the mean number of arteries with at least 70% diameter stenosis was 2.0 +/- 0.2 in group I and 2.2 +/- 0.2 in group II (difference not significant).(ABSTRACT TRUNCATED AT 250 WORDS)
对60例急性心肌梗死（AMI）后11±1天有或无心绞痛症状且对诺顿运动平板试验有阳性反应（至少2个导联ST段压低至少1.5 mm或铊再灌注异常）的患者进行了研究。所有患者在梗死24±4天后均接受了冠状动脉造影。38例患者（63%）无运动平板心绞痛（无症状性心肌缺血，I组），22例患者有典型运动平板心绞痛（症状性心肌缺血，II组）。运动试验时β受体阻滞剂、钙拮抗剂和硝酸盐的使用在两组间无差异。9例糖尿病患者均在无症状组（p<0.40），I组下壁AMI的比例（38例中的30例）高于II组（22例中的11例，p=0.02）。两组的运动平板试验总时长（I组422±31秒，II组400±46秒）和心率血压乘积无差异。两组中无法运动5分钟的患者数量（I组12例，II组7例）、有弥漫性心电图改变的患者数量（I组9例，II组7例）以及血压反应不足的患者数量（I组8例，II组4例）也相似。在冠状动脉造影时，I组至少70%直径狭窄的动脉平均数量为2.0±0.2，II组为2.2±0.2（差异无统计学意义）。（摘要截断于250字）
