动态心电图在评估经皮冠状动脉腔内血管成形术（PTCA）围手术期心肌缺血药物治疗中的应用及局限性

Use and limitations of Holter electrocardiography in assessing drug therapy of myocardial ischemia during the peri-PTCA period.

作者信息

Lewis B S, Palti A, Merdler A, Karban E, Halon D A

机构信息

Department of Cardiology, Lady Davis Carmel Hospital, Haifa, Israel.

出版信息

Cardiology. 1994;85(1):28-35. doi: 10.1159/000176643.

DOI:10.1159/000176643

PMID:7954555

Abstract

Incidence and pattern of myocardial ischemia during the peri-PTCA (percutaneous transluminal coronary angioplasty) period and the possible role of continuous intravenous isosorbide dinitrate in its prevention were examined prospectively in 30 patients. Holter electrocardiographic monitoring was performed for 21 +/- 3 h before PTCA and continued during and for 41 +/- 8 h after the procedure. Before PTCA, 19 ischemic episodes were present in 10 (33%) of 30 patients. PTCA produced an abrupt decrease in number (p = 0.015) and duration (p = 0.03) of spontaneous ischemic episodes. The rarity of recurrent myocardial ischemic events by Holter monitoring after PTCA negated any attempt at assessing the efficacy of intravenous isosorbide dinitrate in their prevention. Holter monitoring could not be used as an early predictor of late coronary restenosis.

摘要

对30例患者进行前瞻性研究，以检查经皮腔内冠状动脉成形术（PTCA）围手术期心肌缺血的发生率和模式，以及持续静脉滴注硝酸异山梨酯在预防心肌缺血中的可能作用。在PTCA术前进行21±3小时的动态心电图监测，并在手术期间及术后41±8小时持续监测。PTCA术前，30例患者中有10例（33%）出现19次缺血发作。PTCA使自发性缺血发作的次数（p = 0.015）和持续时间（p = 0.03）急剧减少。PTCA术后通过动态心电图监测复发性心肌缺血事件的罕见性，使得评估静脉滴注硝酸异山梨酯在预防心肌缺血中的疗效的任何尝试都没有意义。动态心电图监测不能作为晚期冠状动脉再狭窄的早期预测指标。