Gasilin V S, Lupanov V P, Mazaev V P, Gadzhaeva F U
Kardiologiia. 1980 Aug;20(8):68-72.
The sensitivity of various criteria of the physical exercise test in revealing myocardial ischemia was studied in 2 groups of patients with ischemic heart disease: 1st group of 64 patients with normal ECG at rest, 2nd group of 96 patients with cicatricial changes in the myocardium. Selective coronography demonstrated atherosclerotic narrowing (stenosis of more than 70%) of one or more coronary arteries of the heart in all patients. During physical exercise an attack of angina pectoris without "ischemic" changes on the ECG occurred in 36.1% of patients of the 1st group and in 22.4% of patients of the 2nd group. The frequency of other clinical signs of cessation of the exercise (dyspnoea, change of arterial pressure, extrasystole and others) was three and a half times higher in patients with cicatricial changes in the myocardium. It is concluded that the frequency with which signs of myocardial ischemia are revealed during physical exercise depends not only on the pronounced character of the pathological coronary condition and the development of collateral circulation but also by the sensitivity of the separate ECG leads and the presence and localization of cicatricial changes in the myocardium.
第一组64例静息心电图正常的患者,第二组96例心肌有瘢痕改变的患者。选择性冠状动脉造影显示所有患者心脏的一支或多支冠状动脉存在动脉粥样硬化性狭窄(狭窄超过70%)。在体育锻炼期间,第一组36.1%的患者和第二组22.4%的患者出现了心绞痛发作但心电图无“缺血性”改变。心肌有瘢痕改变的患者中,运动停止的其他临床体征(呼吸困难、动脉压变化、早搏等)的发生率高出三倍半。得出的结论是,体育锻炼期间揭示心肌缺血体征的频率不仅取决于病理性冠状动脉病变的明显程度和侧支循环的发展,还取决于单独心电图导联的敏感性以及心肌瘢痕改变的存在和定位。