Mitake H, Sawayama T, Nezuo S, Fuseno H, Samukawa M, Hasegawa K, Harada Y
Am J Cardiol. 1984 Jul 1;54(1):79-83. doi: 10.1016/0002-9149(84)90307-2.
The relation between changes in left ventricular systolic time intervals with amyl nitrite (AN) inhalation and the severity of coronary artery disease (CAD) was evaluated in 77 patients who underwent catheterization because of chest pain. In 25 subjects with normal coronary angiograms (control group), AN inhalation increased the ejection time (ET), shortened the preejection period (PEP) and increased the ET/PEP markedly. In the 52 patients with CAD (CAD group), the ET/PEP changed insignificantly after AN. The difference between the 2 groups was significant (p less than 0.001). At cardiac catheterization, the increase of left ventricular dP/dt after AN in the control group was significantly larger than that in the CAD group. Although a positive correlation between changes in ET/PEP with AN and ejection fraction at rest was noted in patients with 1-vessel CAD, no such correlation was noted in those with multivessel CAD. This suggests that factors in addition to pump function, such as the degree of CAD, influence the effect of AN inhalation on systolic time intervals. When an increase of less than 30% in ET/PEP occurs with AN inhalation, the presence of significant CAD can be detected with a sensitivity of 92%, a specificity of 84% and the predictive value of 92%. The AN inhalation test is safe and simple, and thus could serve as a stress test for evaluating the presence and severity of significant CAD.
对77例因胸痛接受心导管检查的患者，评估了吸入亚硝酸异戊酯（AN）时左心室收缩时间间期的变化与冠状动脉疾病（CAD）严重程度之间的关系。在25例冠状动脉造影正常的受试者（对照组）中，吸入AN可使射血时间（ET）延长，射血前期（PEP）缩短，ET/PEP显著增加。在52例CAD患者（CAD组）中，吸入AN后ET/PEP变化不明显。两组之间的差异具有显著性（p<0.001）。在心导管检查时，对照组吸入AN后左心室dP/dt的增加显著大于CAD组。虽然在单支血管CAD患者中，吸入AN时ET/PEP的变化与静息射血分数之间存在正相关，但在多支血管CAD患者中未观察到这种相关性。这表明，除泵功能外，CAD程度等因素也会影响吸入AN对收缩时间间期的作用。当吸入AN时ET/PEP增加小于30%时，检测显著CAD的敏感性为92%，特异性为84%，预测值为92%。吸入AN试验安全简单，因此可作为评估显著CAD的存在和严重程度的一种负荷试验。
