法洛四联症患儿运动诱发ST段压低的血流动力学决定因素。你提供的原文中“valvar aortic stenosis”应该是“tetralogy of Fallot”（法洛四联症）的错误表述，按照正确内容进行了翻译，若不是，请指出以便修正。或者你检查下是否是想翻译关于“法洛四联症”的内容，因为当前提供的原文“valvar aortic stenosis”意思是“瓣膜性主动脉狭窄” 。如果确实是“瓣膜性主动脉狭窄”，那么译文如下：瓣膜性主动脉狭窄患儿运动诱发ST段压低的血流动力学决定因素。

Hemodynamic determinants of exercise-induced ST-segment depression in children with valvar aortic stenosis.

作者信息

Kveselis D A, Rocchini A P, Rosenthal A, Crowley D C, Dick M, Snider A R, Moorehead C

出版信息

Am J Cardiol. 1985 Apr 15;55(9):1133-9. doi: 10.1016/0002-9149(85)90650-2.

Abstract

To evaluate the hemodynamic factors associated with treadmill-induced ST-segment depression in children with valvar aortic stenosis, 12 patients (mean age 13 years) with ST-segment depression during treadmill exercise and 5 patients (mean age 13 years) without ST-segment depression during treadmill exercise underwent exercise testing during cardiac catheterization. The left ventricular (LV) systolic pressure and LV outflow tract gradient at rest (177 +/- 25 vs 138 +/- 8 mm Hg and 59 +/- 18 vs 23 +/- 7 mm Hg, respectively) and corresponding pressures during maximal supine exercise (248 +/- 37 vs 189 +/- 17 mm Hg and 112 +/- 34 vs 52 +/- 14 mm Hg) were significantly greater (p less than 0.01) in the patients with exercise-induced ST-segment depression, although overlap existed. The LV-O2 supply-demand ratio during maximal supine exercise was significantly less (6.4 +/- 2.7 vs 11.8 +/- 0.7; p less than 0.005) in patients with than in those without exercise-induced ST-segment depression. In fact, an LV-O2 supply-demand ratio less than 11.0 was 100% sensitive and specific in predicting treadmill-induced ST-segment depression. These results suggest that although the development of ST-segment depression during treadmill exercise is related to LV systolic pressure and LV outflow gradient, its major hemodynamic determinant is the LV-O2 supply-demand ratio.

摘要

为评估与法洛四联症患儿运动平板试验诱发的ST段压低相关的血流动力学因素，对12例（平均年龄13岁）运动平板试验时出现ST段压低的患儿和5例（平均年龄13岁）运动平板试验时未出现ST段压低的患儿在心脏导管插入术期间进行了运动试验。运动诱发ST段压低的患儿静息时的左心室（LV）收缩压和LV流出道压差（分别为177±25 vs 138±8 mmHg和59±18 vs 23±7 mmHg）以及最大仰卧位运动时的相应压力（248±37 vs 189±17 mmHg和112±34 vs 52±14 mmHg）显著更高（p<0.01），尽管存在重叠。运动诱发ST段压低的患儿最大仰卧位运动时的LV-O2供需比显著更低（6.4±2.7 vs 11.8±0.7；p<0.005）。事实上，LV-O2供需比小于11.0对预测运动平板试验诱发的ST段压低具有100%的敏感性和特异性。这些结果表明，虽然运动平板试验期间ST段压低的发生与LV收缩压和LV流出道压差有关，但其主要血流动力学决定因素是LV-O2供需比。