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冠状动脉搭桥术对劳力性心绞痛影响的运动试验系列评估(作者译)

[Serial evaluation by effort test of the effects of coronary artery bypass on effort angina (author's transl)].

作者信息

de Caprio L, Cuomo S, Meccariello P, di Lello F, Postiglione M, de Amicis V, Romano M, Rengo F

出版信息

G Ital Cardiol. 1981;11(12):2056-63.

PMID:6980800
Abstract

To evaluate the duration of favourable effects of coronary artery bypass (CAB) on exercise-induced angina (A), 58 patients: 13 with single 21 with double and 24 with triple vessel disease, were studied. All patients underwent CAB for stable angina on effort. Patients underwent exercise testing (ET) before surgery at one, two and three years. Heart rate peak (HR), HR x systolic blood pressure peak (DP), work load (W), exercise-induced ST segment depression (ST) and incidence of A were evaluated; the results of ET before surgery were compared with those found after CAB. Our findings show that HR, DP, W and ST were significantly improved by surgery for at least 3 years. The lowest incidence of A was found at one year ET (20.6%), while it increased at two years (27,5%) and three years ET (37.9%). Most patients with A had angiographic evidence of left ventricular abnormal wall motion and ec-graphic signs of previous myocardial infarction. Our data indicate that serial exercise testing can objectively monitor the results of CAB. Most patients show an improved exercise tolerance for up to 3 years after CAB. Some patients, with more extensive CAD, showed a progressive deterioration of the clinical pattern and a decrease of the exercise tolerance.

摘要

为评估冠状动脉搭桥术(CAB)对运动诱发型心绞痛(A)的有益作用持续时间,我们对58例患者进行了研究,其中13例为单支血管病变,21例为双支血管病变,24例为三支血管病变。所有患者均因劳力性稳定型心绞痛接受CAB手术。患者在术前1年、2年和3年接受运动试验(ET)。评估心率峰值(HR)、心率×收缩压峰值(DP)、工作量(W)、运动诱发的ST段压低(ST)以及心绞痛发生率;将术前ET结果与CAB术后结果进行比较。我们的研究结果表明,手术至少3年内HR、DP、W和ST均有显著改善。1年ET时心绞痛发生率最低(20.6%),而在2年(27.5%)和3年ET时增加(37.9%)。大多数心绞痛患者有左心室壁运动异常的血管造影证据和既往心肌梗死的心电图表现。我们的数据表明,系列运动试验可客观监测CAB的效果。大多数患者在CAB术后长达3年内运动耐量得到改善。一些患有更广泛冠心病的患者临床症状逐渐恶化,运动耐量下降。

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