Comparison of upright and supine bicycle exercise in the detection and evaluation of extent of coronary artery disease by equilibrium radionuclide ventriculography.
Comparison of upright and supine bicycle exercise in the detection and evaluation of extent of coronary artery disease by equilibrium radionuclide ventriculography.
复制标题
平衡放射性核素心室造影检测和评估冠状动脉疾病程度的直立和仰卧自行车运动的比较。
DOI：
10.1016/s0002-8703(81)80007-5
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发表时间：
1981
影响因子：
4.8
通讯作者：
Forrester,J
中科院分区：
文献类型：
--
作者：
Freeman,MR;Berman,DS;Staniloff,H;Elkayam,U;Maddahi,J;Swan,HJ;Forrester,J
对37例患者进行了静息和最大负荷运动时的直立和仰卧位多门控心血池造影，其中15例冠状动脉造影正常，12例无心肌梗死（MI）的冠状动脉疾病（CAD），10例CAD和既往MI。正常患者在直立和仰卧运动时心率和收缩压相似，但两组CAD患者在仰卧运动时心率和收缩压显著降低。各组在休息或最大运动时直立和仰卧位的左心室（LV）射血分数（EF）、右心室（RV）EF和LV节段性室壁运动相似，运动反应高度一致。尽管三组患者在直立运动时左室舒张末期容积增加，两组冠心病患者在仰卧运动时左室舒张末期容积增加，但无冠心病患者在仰卧运动时左室舒张末期容积没有变化。正常人仰卧位运动时左室收缩末期容积下降幅度大于直立位运动时。两种体位下冠心病患者左室收缩末期容积均增加。因此，尽管直立位和仰卧位的LVEF、RVEF和LV节段性室壁运动反应相似，但LV收缩末期和LV舒张末期容积变化不同。对于检测和评估CAD，两种不同的运动位置似乎具有相似的诊断内容。
Upright and supine multiple gated cardiac blood pool scintigraphy was performed at rest and during maximum exercise in 37 patients, 15 with normal coronary arteriograms, 12 with coronary artery disease (CAD) without myocardial infarction (MI), and 10 with CAD and previous MI. Heart rate and systolic blood pressure were similar during upright and supine exercise in normal patients, but were significantly lower during supine exercise in both CAD groups. Left ventricular (LV) ejection fraction (EF), right ventricular (RV) EF, and LV segmental wall motion were similar in the upright and supine positions at rest or during maximum exercise within each group and showed high concordance of exercise responses. Although LV end-diastolic volume increased in all three groups during upright exercise and in both CAD groups when exercised supine, it did not change during supine exercise in patients without CAD. The fall of LV end-systolic volume in normals was greater during supine exercise than during upright exercise. LV end-systolic volume rose in the CAD patients in both positions. Therefore, although LVEF, RVEF, and LV segmental wall motion responses are similar in the upright and supine positions, LV end-systolic and LV end-diastolic volume changes are not. For detecting and evaluating CAD, the two different positions of exercise appear to have similar diagnostic content.