SILENT MYOCARDIAL ISCHAEMIA DUE TO MENTAL STRESS
SILENT MYOCARDIAL ISCHAEMIA DUE TO MENTAL STRESS
复制标题
精神压力导致的无症状性心肌缺血
DOI：
10.1016/s0140-6736(84)91106-1
复制
发表时间：
1984
期刊：
影响因子：
--
通讯作者：
A. Selwyn
中科院分区：
文献类型：
--
作者：
J. Deanfield;M. Kensett;R. Wilson;M. Shea;P. Horlock;C. Landsheere;A. Selwyn
心绞痛和冠状动脉疾病的患者有许多无症状的短暂性心肌缺血发作，其中大多数不能用体力消耗来解释。对16例典型稳定型心绞痛患者进行了检查，以检验这些发作可由日常事件（如精神活动的变化）触发的假设。在心算和体育锻炼后，通过正电子断层扫描测量铷-82的摄取来评估局部心肌灌注和缺血。心算显示12例（75%）患者局部灌注异常，仅6例伴ST段压低，其中4例伴心绞痛，6例灌注异常，但无疼痛或心电图改变。运动后，所有患者在心算缺血的节段均显示局部心肌灌注异常。所有患者均伴有ST段压低，15例伴有心绞痛。精神活动和心肌缺血之间的联系在日常生活中可能经常发生，并可以解释冠心病患者的许多短暂和无症状的心电图变化。
Patients with angina and coronary disease have many episodes of symptomless transient myocardial ischaemia, most of which cannot be explained by physical exertion. 16 patients with typical stable angina pectoris were examined to test the hypothesis that these episodes can be triggered off by ordinary daily events, such as changes in mental activity. Regional myocardial perfusion and ischaemia were assessed by measurement of the uptake of rubidium-82 with positron tomography after mental arithmetic and physical exercise. With mental arithmetic, 12 (75%) patients had abnormalities of regional perfusion, accompanied in only 6 by ST-segment depression and in 4 of these 6 by angina, leaving 6 patients with perfusion abnormalities but neither pain nor electrocardiographic changes. After exercise, all the patients showed abnormal regional myocardial perfusion in the segments that became ischaemic with mental arithmetic. This was accompanied by ST depression in all and angina in 15. The association between mental activity and myocardial ischaemia may operate frequently during everyday life and may explain many of the transient and symptomless electrocardiographic changes in patients with coronary disease.