作为心绞痛患者运动期间心肌耗氧量指标的心率血压乘积

The rate-pressure product as an index of myocardial oxygen consumption during exercise in patients with angina pectoris.

作者信息

Gobel F L, Norstrom L A, Nelson R R, Jorgensen C R, Wang Y

出版信息

Circulation. 1978 Mar;57(3):549-56. doi: 10.1161/01.cir.57.3.549.

DOI:10.1161/01.cir.57.3.549

Abstract

In order to evaluate hemodynamic predictors of myocardial oxygen consumption (MVO2), 27 normotensive men with angina pectoris were studied at rest and during a steady state at sympton-tolerated maximal exercise (STME). Myocardial blood flow (MBF) was measured by the nitrous oxide method using gas chromatography. MBF increased by 71% from a resting value of 57.4 +/- 10.2 to 98.3 +/- 15.6 ml/100 g LV/min (P less than 0.001) during STME while MVO2 increased by 81% from a resting value of 6.7 +/- 1.3 to 12.1 +/- 2.8 ml O2/100 g LV/min (P less than 0.001). MVO2 correlated well with heart rate (HR) (r = 0.79), with HR x blood pressure (BP) (r = 0.83), and, adding end-diastolic pressure and peak LV dp/dt as independent variables, slightly improved this correlation (r = .86). Including the ejection period (tension-time index) did not improve the correlation (r = 0.80). Thus, HR and HR x BP, both easily measured hemodynamic variables, are good predictors of MVO2 during exercise in normotensive patients with ischemic heart disease. Including variables reflecting the contractile state of the heart and ventricular volume may further improve the predictability.

摘要

为了评估心肌耗氧量（MVO2）的血流动力学预测指标，对27名患有心绞痛的血压正常男性在静息状态以及症状耐受的最大运动（STME）稳态期间进行了研究。采用气相色谱法通过一氧化二氮法测量心肌血流量（MBF）。在STME期间，MBF从静息值57.4±10.2增加71%至98.3±15.6 ml/100 g左心室/分钟（P<0.001），而MVO2从静息值6.7±1.3增加81%至12.1±2.8 ml O2/100 g左心室/分钟（P<0.001）。MVO2与心率（HR）相关性良好（r = 0.79），与心率×血压（BP）相关性良好（r = 0.83），并且将舒张末期压力和左心室dp/dt峰值作为自变量加入后，这种相关性略有改善（r = 0.86）。纳入射血期（张力 - 时间指数）并未改善相关性（r = 0.80）。因此，HR和HR×BP这两个易于测量的血流动力学变量是血压正常的缺血性心脏病患者运动期间MVO2的良好预测指标。纳入反映心脏收缩状态和心室容积的变量可能会进一步提高预测能力。