Roskamm H, Samek L, Zweigle K, Stürzenhofecker P, Petersen J, Rentrop P, Prokoph J
Z Kardiol. 1977 Jun;66(6):273-80.
In 311 patients (269 men and 42 woman, 20 to 65 years old) without transmural myocardial infarction the results of exercise tests in supine position were compared with the results of coronary angiography. 1. Patients having ischemic ST-segment depression (greater than or equal to 0.1 mV) and angina pectoris during exercise (n = 108) showed a greater than or equal to 50% stenosis of at least one vessel in 86.1%. In men the number of a greater than or equal to 50% stenosis was significantly higher than in women (91.3 vs. 56.2%). In patients without digitalis agreement with coronary angiographic findings is higher than in patients with digitalis (92.7 vs. 79.2%). After excluding women, patients under digitalis and those with an intramural myocardial infarction, agreement was 96.8%. 2. In patients having ischemic ST-segment depression agreement was 30% and in those with angina pectoris 36.8%. 3. In patients having neither ischemic ST-segment depression nor angina pectoris during exercise up to a heart rate of 80% of the age-dependent heart rate limit a coronary angiogram without a greater than or equal to 50% stenosis was found in 87.6%. After excluding patients with an intramural myocardial infarction, women and patients under digitalis, agreement increased to 97.9%. 4. In patients having both ischemic ST-segment depression and angina pectoris during exercise a 2- or 3-vessel disease was more often found than in patients having either ischemic ST-segment depression or angina pectoris, or in those having neither ischemic ST-segment depression nor angina pectoris respectively (57.5% vs. 16.6, 8.9 and 1.9%). 5. The number of positive coronary angiograms, especially of 2- and 3-vessel disease, increases with the degree of an ischemic ST-segment depression and the reduction of exercise tolerance.
在311例无透壁性心肌梗死的患者(269例男性和42例女性,年龄20至65岁)中,将仰卧位运动试验结果与冠状动脉造影结果进行了比较。1. 运动期间出现缺血性ST段压低(≥0.1 mV)和心绞痛的患者(n = 108)中,86.1%显示至少一支血管有≥50%的狭窄。男性中≥50%狭窄的数量显著高于女性(91.3%对56.2%)。未使用洋地黄的患者与冠状动脉造影结果的一致性高于使用洋地黄的患者(92.7%对79.2%)。排除女性、使用洋地黄的患者和有壁内心肌梗死的患者后,一致性为96.8%。2. 有缺血性ST段压低的患者一致性为30%,有心绞痛的患者一致性为36.8%。3. 在运动期间心率达到年龄相关心率极限的80%时既无缺血性ST段压低也无心绞痛的患者中,87.6%的冠状动脉造影未发现≥50%的狭窄。排除有壁内心肌梗死的患者、女性和使用洋地黄的患者后,一致性提高到97.9%。4. 运动期间既有缺血性ST段压低又有心绞痛的患者比分别只有缺血性ST段压低或心绞痛,或既无缺血性ST段压低也无心绞痛的患者更常发现双支或三支血管病变(57.5%对16.6%、8.9%和1.9%)。5. 阳性冠状动脉造影的数量,尤其是双支和三支血管病变的数量,随着缺血性ST段压低程度和运动耐量降低而增加。