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[运动试验在典型稳定型劳力性心绞痛诊断中的应用(作者译)]

[The effort test in the diagnosis of typical stable effort angina (author's transl)].

作者信息

De Vita C, Ciliberto G R, Gibelli G, Carù B

出版信息

G Ital Cardiol. 1977;7(11):1047-56.

PMID:924065
Abstract

Among 173 patients with typical effort angina (159 men and 14 women) which underwent exercise test and coronary angiography, significant stenosis (greater than or equal to 70%) of one or more of important coronary branches were present in 93,1% of the cases (96,3% among the males and 57% among the females). In the same group the exercise test sensitivity was 88,8%; when 3 coronary branches were involved the sensitivity rises to 94,3%. The 96,6% of patients with positive exercise test had coronary lesions too (true positives). We did not find any correspondence between the site of transient subendocardial ischemia occurred during the exercise test and coronary branch involved, when the stenosis was limited only one important coronary branch. Finally the researche of correlation between the entity of coronary disease (number of coronary vessels involved, entity of left ventricular contractility impairment) and behavior of patient during exercise test, evaluated with different parameters measured at the moment of stopping of exercise (heart rate and threshold work load, rate-pressure product, maximal downsloping of ST segment, different positivity criteria for exercise test) allowed us to show a good correlation only between the extent of coronary involvement and rate-pressure product or maximal downsloping of ST segment.

摘要

在173例接受运动试验和冠状动脉造影的典型劳力性心绞痛患者(159例男性和14例女性)中,93.1%的病例存在一支或多支重要冠状动脉分支的显著狭窄(大于或等于70%)(男性中为96.3%,女性中为57%)。在同一组中,运动试验的敏感性为88.8%;当三支冠状动脉分支受累时,敏感性升至94.3%。运动试验阳性的患者中有96.6%也有冠状动脉病变(真阳性)。当狭窄仅局限于一支重要冠状动脉分支时,我们未发现运动试验期间发生的短暂心内膜下缺血部位与受累冠状动脉分支之间存在任何对应关系。最后,研究冠状动脉疾病的程度(受累冠状动脉血管数量、左心室收缩功能损害程度)与运动试验期间患者行为之间的相关性,通过运动停止时测量的不同参数(心率和阈工作负荷、心率-血压乘积、ST段最大下斜程度、运动试验的不同阳性标准)进行评估,结果显示仅冠状动脉受累程度与心率-血压乘积或ST段最大下斜程度之间存在良好的相关性。

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