Krittayaphong R, Light K C, Biles P L, Ballenger M N, Sheps D S
Department of Cardiology, University of North Carolina School of Medicine, Chapel Hill, USA.
Am J Cardiol. 1995 Oct 1;76(10):657-60. doi: 10.1016/s0002-9149(99)80192-1.
This study assessed the relation between hemodynamic data during a standardized mental stressor and ambulatory ischemia to determine if laboratory-induced responses could predict the magnitude of daily life ischemia. Forty-two men and 11 women, aged 46 to 79 years (mean 61), with coronary artery disease and exercise-induced ischemia were studied. All patients underwent 24- to 48-hour ambulatory electrocardiographic (ECG) monitoring (mean 43 +/- 0.8 hours) and laboratory-induced mental stress using a public speaking task. Hemodynamic data were obtained at rest and every minute during mental stress. Thirty-three of 53 patients (62%) had at least 1 ischemic episode during ECG monitoring. In patients who had ambulatory ischemia, there was a mean number of 7.9 +/- 1.8 episodes (mean total duration 79.2 +/- 24.1 minutes/48 hours). Significant positive correlations were found for peak heart rate and changes in heart rate during mental stress and ambulatory ischemia (r = 0.353 to 0.462, p < 0.05) in patients who had ambulatory ischemia. There was no correlation between systolic blood pressure during mental stress and ambulatory ischemia. Results of this study demonstrate that heart rate response during laboratory-induced mental stress correlates with magnitude of ischemia on ambulatory ECG monitoring in patients with coronary artery disease.
本研究评估了标准化精神应激源期间的血流动力学数据与动态心肌缺血之间的关系，以确定实验室诱导的反应是否能够预测日常生活中的缺血程度。对42名男性和11名女性进行了研究，年龄在46至79岁之间（平均61岁），患有冠状动脉疾病且有运动诱发的心肌缺血。所有患者均接受了24至48小时的动态心电图（ECG）监测（平均43±0.8小时），并通过公开演讲任务进行实验室诱导的精神应激。在静息状态和精神应激期间每分钟获取血流动力学数据。53名患者中有33名（62%）在ECG监测期间至少有1次缺血发作。在有动态心肌缺血的患者中，平均发作次数为7.9±1.8次（平均总持续时间79.2±24.1分钟/48小时）。在有动态心肌缺血的患者中，发现精神应激期间的心率峰值和心率变化与动态心肌缺血之间存在显著正相关（r = 0.353至0.462，p < 0.05）。精神应激期间的收缩压与动态心肌缺血之间无相关性。本研究结果表明，在患有冠状动脉疾病的患者中，实验室诱导的精神应激期间的心率反应与动态ECG监测中的缺血程度相关。
