Ivert T, Holmgren A, Landou C
Scand J Thorac Cardiovasc Surg. 1981;15(2):179-95. doi: 10.3109/14017438109101044.
Exercise on a bicycle ergometer was used to assess symptom-limited working capacity (Wsl) five years after coronary bypass surgery. Ninety-six patients were evaluated with a sitting bicycle test using 10 Watt increments of work load every minute from an initial load of 10 Watt. Ninety-three per cent had less symptoms than before surgery and 32% said they had no angina. Angina was provoked at exercise in 1/31 asymptomatic patients (3%) and in 46/65 (71%) of those with residual symptoms. The Wsl of 50-250 Watt (mean 143 Watt) in a asymptomatic patients was significant higher than 30-220 Watt (mean 105 Watt) performed by patients with residual angina. In 61 patients, exercise tests were performed before, one year and five years after the operation. Average Wsl was significantly higher after one year (127; 36 Watt) than before surgery (90; 23 Watt). but declined significantly until the five-year evaluation (113; 37 Watt). After one year 82% had a higher Wsl than prior to operation compared to 69% five years after surgery. Angiography five years after surgery revealed that 60/76 subjects (79%) had all grafts patent and 16/76 (21%) one or more grafts occluded. In spite of one or more grafts occluded. 2/16 patients (13%) were asymptomatic, whereas 25/60 (42%) with all grafts patent were free from symptoms. Average Wsl was significantly higher in patient with all grafts patent (130; 44 Watt) compared to patients with one or more grafts occluded (102; 33 Watt). It is concluded that although subjective improvement after coronary bypass surgery persisted in about 90% of the patients for five years, bicycle exercise tests show a significant decline of Wsl after the first year, but five years after surgery was still better than before the operation.
在冠状动脉搭桥手术后五年，使用自行车测力计运动来评估症状限制下的工作能力（Wsl）。对96名患者进行了坐位自行车测试，从初始负荷10瓦开始，每分钟工作负荷以10瓦递增。93%的患者症状比手术前减轻，32%的患者表示没有心绞痛。在1/31（3%）无症状患者和46/65（71%）有残余症状的患者中，运动时诱发了心绞痛。无症状患者的Wsl为50 - 250瓦（平均143瓦），显著高于有残余心绞痛患者的30 - 220瓦（平均105瓦）。对61名患者在手术前、术后一年和五年进行了运动测试。术后一年的平均Wsl（127；36瓦）显著高于手术前（90；23瓦），但到五年评估时显著下降（113；37瓦）。术后一年，82%的患者Wsl高于术前，而术后五年这一比例为69%。术后五年的血管造影显示，76名受试者中有60名（79%）所有移植血管通畅，16名（21%）有一根或多根移植血管闭塞。尽管有一根或多根移植血管闭塞，16名患者中有2名（13%）无症状，而60名所有移植血管通畅的患者中有25名（42%）无症状。所有移植血管通畅的患者平均Wsl（130；44瓦）显著高于有一根或多根移植血管闭塞的患者（102；33瓦）。结论是，尽管冠状动脉搭桥手术后约90%的患者主观改善持续了五年，但自行车运动测试显示，术后第一年Wsl显著下降，但术后五年仍比手术前好。
