Schiffer F, Hartley L H, Schulman C L, Abelmann W H
Br Heart J. 1980 Jul;44(1):62-6. doi: 10.1136/hrt.44.1.62.
Twelve executives with typical angina pectoris, given a 12-minute quiz, designed to be psychologically stressful, responded with ST depressions of greater than or equal to 1.0 mm. Each of these patients was given an exercise tolerance test on an upright bicycle to induce an amount of ST depression equivalent to that observed during the quiz. A statistical analysis was made of the products of the heart rate and the systolic blood pressure (rate-pressure product), at the onset of equivalent ST depression on both tests. At the maximal ST depression during the quiz, the mean rate-pressure product was 181 +/- 64 (SD) X 10(2), and at an equivalent ST depression during exercise it was 225 +/- 54 X 10(2); the mean difference was 44 +/- 40 X 10(2). Inasmuch as the rate-pressure product is an index of myocardial oxygen consumption, the differences in rate-pressure product suggest that myocardial ischaemia occurred at a lower myocardial oxygen consumption during emotional stress than during exercise. If equivalent degrees of ST depression during exercise and the quiz are indicative of equivalent ischaemia, than a relative reduction in coronary blood flow during emotional stress, probably by coronary spasm, may be postulated as the most reasonable explanation for these observations.
12名患有典型心绞痛的高管接受了一项为期12分钟、旨在造成心理压力的测试，结果显示他们的ST段压低大于或等于1.0毫米。这些患者每人都在直立式自行车上进行了运动耐力测试，以诱发与测试期间观察到的ST段压低程度相当的情况。对两项测试中出现同等ST段压低时的心率与收缩压乘积（心率 - 血压乘积）进行了统计分析。在测试期间出现最大ST段压低时，平均心率 - 血压乘积为181±64（标准差）×10²，而在运动期间出现同等ST段压低时为225±54×10²；平均差值为44±40×10²。由于心率 - 血压乘积是心肌耗氧量的一个指标，心率 - 血压乘积的差异表明，与运动期间相比，情绪应激期间心肌缺血发生在较低的心肌耗氧量水平。如果运动和测试期间同等程度的ST段压低表明同等程度的缺血，那么情绪应激期间冠状动脉血流的相对减少，可能是由于冠状动脉痉挛，也许可以被假定为对这些观察结果最合理的解释。
