Hammond H K, Kelly T L, Froelicher V F
J Am Coll Cardiol. 1985 Jan;5(1):59-69. doi: 10.1016/s0735-1097(85)80085-1.
The purpose of this study was to investigate the relations among four exercise-induced phenomena--angina, ST segment depression, decrease in ejection fraction and thallium perfusion defects--and to determine their impact on aerobic capacity. One hundred fifty-six men (mean age 52 +/- 8 years) with documented coronary heart disease were studied with radionuclide ventriculography during supine bicycle exercise, thallium scintigraphy and treadmill testing with computerized electrocardiography and maximal oxygen uptake. Of 624 administered tests, 243 results (39%) were considered to indicate ischemia. The average number of abnormal tests was 1.6 per patient and, when considered as continuous variables, their results correlated poorly. Correlations did not improve when adjusting for heart rate achieved or by eliminating patients with coronary artery bypass surgery or myocardial infarction. Statistical methods of comparing degree of interest agreement yielded surprisingly weak relations among the four tests of ischemia. Treadmill performance was markedly impaired by angina, but much less impaired by other indicators of ischemia. It is concluded that the usual test responses implying ischemia have weak agreement when uniformly applied to patients with known coronary artery disease.
本研究的目的是调查四种运动诱发现象——心绞痛、ST段压低、射血分数降低和铊灌注缺损——之间的关系，并确定它们对有氧运动能力的影响。对156名有冠心病记录的男性（平均年龄52±8岁）进行了研究，在仰卧位自行车运动、铊闪烁扫描以及使用计算机心电图和最大摄氧量的跑步机测试期间进行放射性核素心室造影。在624项所进行的测试中，243项结果（39%）被认为表明存在缺血。每位患者异常测试的平均数量为1.6项，当将这些结果视为连续变量时，它们之间的相关性很差。在对达到的心率进行校正或排除接受冠状动脉搭桥手术或心肌梗死的患者后，相关性并未改善。比较感兴趣程度一致性的统计方法显示，这四项缺血测试之间的关系出奇地弱。跑步机运动表现受到心绞痛的显著损害，但受其他缺血指标的损害要小得多。得出的结论是，当统一应用于已知冠心病患者时，通常暗示缺血的测试反应一致性较弱。
