Gibbons R J, Lee K L, Cobb F, Jones R H
Circulation. 1981 Nov;64(5):952-7. doi: 10.1161/01.cir.64.5.952.
In this study we describe the ejection fraction response to upright exercise using first-pass radionuclide angiocardiography in a group of 60 patients with chest pain, normal coronary arteriograms and normal resting ventricular function. A wide range of resting function (heart rate and ejection fraction) and exercise function (heart rate, ejection fraction, peak work load and estimated peak oxygen uptake) were measured. The ejection fraction response to exercise demonstrated wide variation, ranging from a decrease of 23% to an increase of 24%. Six of 22 clinical and radionuclide angiocardiographic variables (resting ejection fraction, peak work load, age, sex, body surface area and the change in end-diastolic volume index with exercise) were significant univariate predictors of the ejection fraction response to exercise. Multivariable analysis identified resting ejection fraction, the change in end-diastolic volume index with exercise and either sex or peak work load as variables that provided significant independent predictive information. These observations indicate that the ejection fraction response to exercise is a complex response that is influenced by multiple physiologic variables. The wide variation in this population suggests that the ejection fraction response to exercise is not a reliable test for the diagnosis of coronary artery disease because of its low specificity.
在本研究中，我们使用首次通过放射性核素血管造影术描述了一组60例胸痛患者、冠状动脉造影正常且静息心室功能正常者对直立运动的射血分数反应。测量了广泛的静息功能（心率和射血分数）和运动功能（心率、射血分数、峰值工作量和估计的峰值摄氧量）。运动时的射血分数反应显示出很大差异，从下降23%到增加24%不等。22项临床和放射性核素血管造影变量中的6项（静息射血分数、峰值工作量、年龄、性别、体表面积以及运动时舒张末期容积指数的变化）是运动时射血分数反应的显著单变量预测因素。多变量分析确定静息射血分数、运动时舒张末期容积指数的变化以及性别或峰值工作量为提供显著独立预测信息的变量。这些观察结果表明，运动时的射血分数反应是一种受多种生理变量影响的复杂反应。该人群中的广泛差异表明，运动时的射血分数反应因其特异性低，不是诊断冠状动脉疾病的可靠测试。
