Takahashi H, Bekki H, Koga Y, Utsu F, Nagata H, Itaya M, Ohkita Y, Itaya K, Yoshioka H, Toshima H
J Cardiogr. 1982 Jun;12(2):347-57.
Exercise two-dimensional (2-D) echocardiography was performed in patients with suspected coronary artery disease, and exercise induced left ventricular asynergy was evaluated qualitatively and was compared with the coronary artery stenosis and electrocardiographic ST changes. Subjects were 12 patients with angina of effort, 8 patients with spontaneous angina, 8 patients with chest pain syndrome with the normal coronary artery, and 7 patients with hypertrophic cardiomyopathy (HCM). Cases with myocardial infarction were excluded from this study. 1) Left ventricular asynergy during exercise was observed in 10 and ST depression in 11 of 12 patients with angina of effort. In patients with spontaneous angina, left ventricular asynergy and ST depression during exercise were observed in 2 of 8 patients without anginal pain, and both patients had coronary artery stenosis of 90% or more. 2) Exercise induced asynergy was also observed in 4 of 7 patients with HCM without coronary artery stenosis. It seemed likely that the markedly hypertrophied myocardium and impairment of left ventricular compliance and relaxation may induce relative myocardial ischemia.
对疑似冠心病患者进行二维(2-D)超声心动图检查,并对运动诱发的左心室运动不协调进行定性评估,并与冠状动脉狭窄和心电图ST段改变进行比较。受试者包括12例劳力性心绞痛患者、8例自发性心绞痛患者、8例冠状动脉正常的胸痛综合征患者和7例肥厚型心肌病(HCM)患者。本研究排除了心肌梗死病例。1)12例劳力性心绞痛患者中,10例观察到运动时左心室运动不协调,11例出现ST段压低。在自发性心绞痛患者中,8例无胸痛患者中有2例在运动时观察到左心室运动不协调和ST段压低,这2例患者的冠状动脉狭窄均达90%或以上。2)7例无冠状动脉狭窄的HCM患者中,4例也观察到运动诱发的运动不协调。似乎明显肥厚的心肌以及左心室顺应性和舒张功能受损可能诱发相对性心肌缺血。