Shell W E
Am J Cardiol. 1985 Dec 27;56(17):23I-27I. doi: 10.1016/0002-9149(85)90704-0.
Studies of the mechanisms and characteristics of ischemic heart disease have increasingly documented evidence of myocardial ischemia in the absence of symptoms. Recent work using objective criteria of ischemic events has confirmed that angina pectoris or its equivalents need not accompany true myocardial ischemia, and this appears to be quite common. The impact of these findings on prognosis awaits further study, but preliminary data suggest an improved prognosis for persons in whom coronary artery disease remains asymptomatic compared with symptomatic patients. Further, reduction of silent ischemic events with nitrate therapy may be associated with a more benign subsequent course. Preliminary trials show a reduction of the number, duration and magnitude of silent ischemic events by transdermal nitroglycerin. Ongoing technical innovations in monitoring systems should allow more complete characterization of this syndrome and lead to definition of medical therapy for it.
对缺血性心脏病机制和特征的研究越来越多地记录了无症状心肌缺血的证据。最近使用缺血事件客观标准的研究证实，心绞痛或其等效症状不一定伴随真正的心肌缺血，而且这种情况似乎相当常见。这些发现对预后的影响有待进一步研究，但初步数据表明，与有症状的患者相比，冠状动脉疾病无症状患者的预后有所改善。此外，用硝酸盐疗法减少无症状缺血事件可能与随后更良性的病程相关。初步试验表明，经皮硝酸甘油可减少无症状缺血事件的数量、持续时间和严重程度。监测系统中不断进行的技术创新应能更全面地描述这一综合征，并为其确定药物治疗方法。
