Scherhag A W, Pfleger S, de Mey C, Schreckenberger A B, Staedt U, Heene D L
Medical Clinic, Faculty for Clinical Medicine at Mannheim, University of Heidelberg, Mannheim, Germany.
J Clin Pharmacol. 1997 Jan;37(S1):21S-28S. doi: 10.1177/009127009703700118.
The contribution of computerized impedance cardiography in monitoring and differentiating cardiovascular responses to pharmacologic stress after the administration of dipyridamole (group 1, n = 24) or dobutamine (group 2, n = 26) was investigated during stress echocardiography. Heart rate, stroke volume index, cardiac index and systemic vascular resistance index were evaluated continuously with an automated, computerized, signal-averaged impedance cardiography system. Dipyridamole had little average effect on heart rate, stroke volume index, and cardiac index. The responses were similar in patients with positive (n = 9) or negative (n = 15) stress echocardiography test results (as characterized by echocardiographic wall-motion abnormalities). Dobutamine induced a similar mean increase in heart rate in patients with negative (n = 13) or positive (n = 13) results on stress echocardiography. The mean increase in stroke volume index induced by dobutamine was greater in patients with negative stress echocardiography test results than in patients with stress-induced wall-motion abnormalities. This distinction was also seen in the cardiac index; the mean change in patients with negative stress echocardiography test results was larger than in patients with positive results. It is concluded that automated computerized impedance cardiography not only allows surveying and monitoring hemodynamic changes during pharmacologic stress echocardiography but also contributes to differentiation of pathologic stress responses.
在负荷超声心动图检查期间，研究了计算机化阻抗心动图在监测和区分双嘧达莫（第1组，n = 24）或多巴酚丁胺（第2组，n = 26）给药后心血管对药物应激反应方面的作用。使用自动化、计算机化、信号平均阻抗心动图系统持续评估心率、每搏量指数、心脏指数和全身血管阻力指数。双嘧达莫对心率、每搏量指数和心脏指数的平均影响较小。在负荷超声心动图检查结果为阳性（n = 9）或阴性（n = 15）的患者中（以超声心动图壁运动异常为特征），反应相似。多巴酚丁胺在负荷超声心动图检查结果为阴性（n = 13）或阳性（n = 13）的患者中引起的心率平均升高相似。多巴酚丁胺引起的每搏量指数平均升高在负荷超声心动图检查结果为阴性的患者中大于有应激诱导壁运动异常的患者。在心脏指数方面也观察到这种差异；负荷超声心动图检查结果为阴性的患者的平均变化大于阳性结果的患者。结论是，自动化计算机化阻抗心动图不仅允许在药物负荷超声心动图检查期间监测血流动力学变化，而且有助于区分病理性应激反应。
