McKirnan M D, Sullivan M, Jensen D, Froelicher V F
J Am Coll Cardiol. 1984 Feb;3(2 Pt 1):253-61. doi: 10.1016/s0735-1097(84)80008-x.
To investigate the cardiac determinants of treadmill performance in patients able to exercise to volitional fatigue, 88 patients with coronary heart disease free of angina pectoris were tested. The exercise tests included supine bicycle radionuclide ventriculography, thallium scintigraphy and treadmill testing with expired gas analysis. The number of abnormal Q wave locations, ejection fraction, end-diastolic volume, cardiac output, exercise-induced ST segment depression and thallium scar and ischemia scores were the cardiac variables considered. Rest and exercise ejection fractions were highly correlated to thallium scar score (r = -0.72 to -0.75, p less than 0.001), but not to maximal oxygen consumption (r = 0.19 to 0.25, p less than 0.05). Fifty-five percent of the variability in predicting treadmill time or estimated maximal oxygen consumption was explained by treadmill test-induced change in heart rate (39%), thallium ischemia score (12%) and cardiac output at rest (4%). The change in heart rate induced by the treadmill test explained only 27% of the variability in measured maximal oxygen consumption. Myocardial damage predicted ejection fraction at rest and the ability to increase heart rate with treadmill exercise appeared as an essential component of exercise capacity. Exercise capacity was only minimally affected by asymptomatic ischemia and was relatively independent of ventricular function.
为了研究能够运动至自主疲劳的患者跑步机运动表现的心脏决定因素，对88例无心绞痛的冠心病患者进行了测试。运动测试包括仰卧位自行车放射性核素心室造影、铊闪烁显像以及带有呼出气体分析的跑步机测试。所考虑的心脏变量包括异常Q波位置数量、射血分数、舒张末期容积、心输出量、运动诱发的ST段压低以及铊瘢痕和缺血评分。静息和运动射血分数与铊瘢痕评分高度相关（r = -0.72至-0.75，p < 0.001），但与最大耗氧量不相关（r = 0.19至0.25，p < 0.05）。跑步机测试诱发的心率变化、铊缺血评分以及静息心输出量可解释预测跑步机运动时间或估计最大耗氧量变异性的55%。跑步机测试诱发的心率变化仅解释了实测最大耗氧量变异性的27%。心肌损伤可预测静息射血分数，而跑步机运动时增加心率的能力似乎是运动能力的一个重要组成部分。运动能力仅受到无症状性缺血的轻微影响，并且相对独立于心室功能。
