Huikuri H V, Ikäheimo M J, Linnaluoto M K, Takkunen J T
Acta Med Scand. 1983;213(5):399-404. doi: 10.1111/j.0954-6820.1983.tb03758.x.
In order to evaluate the left ventricular response to isometric exercise in different types of aortic valve disease, isometric exercise tests were performed during cardiac catheterization in 14 patients with pure aortic stenosis, 20 with combined aortic stenosis and regurgitation, and 18 with pure aortic regurgitation. Patients with angina pectoris in whom coronary angiography had not been performed were excluded. Thirty-seven patients were recatheterized 12 months after aortic valve replacement, and the ventricular response to exercise was re-evaluated. Preoperatively, the ejection fraction did not change significantly during exercise in patients with aortic stenosis, tended to decrease in patients with combined valve lesion, and decreased significantly in patients with aortic regurgitation (p less than 0.001). In the three patients whose ejection fraction during preoperative exercise decreased to below 0.40, it remained below 0.50 after successful aortic valve replacement. It appears possible to reveal left ventricular dysfunction in many patients with aortic regurgitation and in some with combined aortic valve disease by means of isometric exercise. The severely depressed ventricular dysfunction during exercise does not appear to correct totally after surgery.
为了评估不同类型主动脉瓣疾病患者左心室对等长运动的反应，对14例单纯主动脉瓣狭窄、20例主动脉瓣狭窄合并反流以及18例单纯主动脉瓣反流患者在心脏导管检查期间进行了等长运动试验。排除未进行冠状动脉造影的心绞痛患者。37例患者在主动脉瓣置换术后12个月再次进行导管检查，并重新评估心室对运动的反应。术前，主动脉瓣狭窄患者运动期间射血分数无明显变化，瓣膜联合病变患者射血分数有下降趋势，主动脉瓣反流患者射血分数显著下降（p<0.001）。术前运动期间射血分数降至0.40以下的3例患者，成功进行主动脉瓣置换术后仍低于0.50。通过等长运动似乎有可能揭示许多主动脉瓣反流患者以及一些主动脉瓣联合疾病患者的左心室功能障碍。运动期间严重降低的心室功能障碍术后似乎并未完全纠正。
