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心肌梗死后的运动试验。与冠状动脉造影和心室造影数据的相关性

[Exercise test after myocardial infarct. Correlations with data of coronary angiography and ventriculography].

作者信息

Cherrier F, Souris D, Beissel J, Neimann J L

出版信息

Arch Mal Coeur Vaiss. 1977 Oct;70(10):1039-47.

PMID:413512
Abstract

The authors have studied the exercise test carried out at least three months (3-6 months: 52 cases; greater than 6 months: 48 cases) after myocardial infarction in the anterior position (50 cases), in the "inferior" position (42 cases), and of a diffuse type (8 cases), in patients who were taking no treatment which might interfere with interpretation of the test. For the anterior infarctions there was a good correlation between ST elevation (J max greater than or equal to 1 mm, or better than the sun of the J greater than or equal to 2 mm) and the presence of severe involvement of the left ventricle. A depressed ST segment beyond the area of necrosis corresponds to a stenosis greater than or equal to 75 p. 100 in 36 p. 100 of cases. In inferior infarctions, the correlation between ST elevation and left ventricular involvement is also specific but less sensitive. ST depression outside the area of necrosis corresponds to a stenosis greater than or equal to 75 p. 100 in 66 p. 100 of cases; it is then lateral, but may extend as far as V2. They also indicate a mirror image, especially when the depressed area slopes upwards, and is localised in V2-V3. The other changes which were found have no practical application.

摘要

作者研究了心肌梗死至少三个月(3 - 6个月:52例;大于6个月:48例)后的运动试验情况,这些患者处于前壁心肌梗死(50例)、“下壁”心肌梗死(42例)和弥漫型心肌梗死(8例),且未接受可能干扰试验解读的治疗。对于前壁梗死患者,ST段抬高(J点最大值大于或等于1毫米,或优于J点大于或等于2毫米之和)与左心室严重受累情况之间存在良好相关性。坏死区域以外的ST段压低在36%的病例中对应于狭窄大于或等于75%。在下壁梗死中,ST段抬高与左心室受累之间的相关性也具有特异性,但敏感性较低。坏死区域以外的ST段压低在66%的病例中对应于狭窄大于或等于75%;其压低部位在侧壁,但可能延伸至V2导联。这些变化还提示存在镜像改变,尤其是当压低区域向上倾斜且位于V2 - V3导联时。发现的其他变化无实际应用价值。

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