Starling M R, Crawford M H, Kennedy G T, O'Rourke R A
Am J Cardiol. 1980 Dec 1;46(6):909-14. doi: 10.1016/0002-9149(80)90344-6.
Recently, modified treadmill exercise testing before hospital discharge has been reported to be safe in patients after uncomplicated myocardial infarction. Accordingly, the frequency of treadmill exercise-induced abnormalities and their prognostic value were evaluated in 130 patients with uncomplicated myocardial infarction. Seventy-eight patients (60 percent) had one or more treadmill exercise-induced abnormalities; 42 had S-T segment depression, 35 had angina and 17 had an inadequate blood pressure response. During the mean follow-up period of 11 months, 27 patients experienced unstable angina, 12 had a recurrent myocardial infarction and 10 died of cardiac causes. Compared with patients with no exercise-induced abnormality, patients with S-T segment depression, angina pectoris or an inadequate blood pressure response had a significantly greater (p < 0.001) incidence of all cardiac events during the follow-up period. Furthermore, unstable angina pectoris was significantly more frequent (p < 0.005) in patients with S-T segment depression or angina pectoris. Finally, when the patients with ischemic treadmill abnormalities were combined with the patients exhibiting an inadequate blood pressure response, they had a statistically greater (p < 0.005) incidence of cardiac death than that of patients with no treadmill abnormalities. Therefore, these three abnormalities during modified treadmill exercise testing before hospital discharge identify patients with uncomplicated myocardial infarction who are at risk for a future cardiac event.
最近，有报道称，在无并发症心肌梗死患者出院前进行改良平板运动试验是安全的。因此，对130例无并发症心肌梗死患者进行了平板运动诱发异常的频率及其预后价值评估。78例患者（60%）出现一项或多项平板运动诱发异常；42例出现S-T段压低，35例出现心绞痛，17例血压反应不足。在平均11个月的随访期内，27例患者发生不稳定型心绞痛，12例发生再发性心肌梗死，10例死于心脏原因。与无运动诱发异常的患者相比，出现S-T段压低、心绞痛或血压反应不足的患者在随访期间所有心脏事件的发生率显著更高（p<0.001）。此外，S-T段压低或心绞痛患者中不稳定型心绞痛明显更常见（p<0.005）。最后，将平板运动缺血异常患者与血压反应不足患者合并后，他们的心脏性死亡发生率在统计学上高于无平板运动异常的患者（p<0.005）。因此，出院前改良平板运动试验中的这三种异常可识别无并发症心肌梗死且未来有心脏事件风险的患者。
