Comparison of the Asymptomatic Cardiac Ischemia Pilot and modified Asymptomatic Cardiac Ischemia Pilot versus Bruce and Cornell exercise protocols.
Comparison of the Asymptomatic Cardiac Ischemia Pilot and modified Asymptomatic Cardiac Ischemia Pilot versus Bruce and Cornell exercise protocols.
复制标题
无症状心脏缺血试验和改良无症状心脏缺血试验与布鲁斯和康奈尔锻炼方案的比较。
DOI：
10.1016/0002-9149(93)90891-f
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
Chaitman,BR
中科院分区：
文献类型：
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作者：
Tamesis,B;Stelken,A;Byers,S;Shaw,L;Younis,L;Miller,DD;Chaitman,BR
开发了无症状心脏缺血试验（ACIP）和改良的ACIP踏车运动方案，以测试冠心病患者，并在各阶段之间线性增加工作负荷。在28例正常人和16例冠心病患者中比较了ACIP和改良ACIP与布鲁斯和Cornell方案的生理变化。在2天内随机分配运动方案，并在每次测试中连续获得气体交换数据。在正常受试者中，4种方案的峰值心率、收缩压、峰值耗氧率（VO 2）和每分钟通气量相似，与ACIP、改良ACIP和Cornell方案相比，布鲁斯方案的运动时间最短（分别为10.2 ± 3.1 vs 13.4 ± 4.9、13.9 ± 4.5和15.0 ± 4.2分钟; p < 0.001）。ACIP方案的VO 2预测值与实测值之间的差异最小（37.0 ± 11.0 vs 35.8 ± 13.5 ml/kg/min），支架方案最大（41.1 ± 11.8 vs 36.7 ± 15.0 ml/ kg/min），正常受试者以及冠心病患者（ACIP方案分别为26.9 ± 7.1 vs 22.5 ± 6.7，Brace方案分别为29.1 ± 7 vs 22.6 ± 5.7 ml/kg/min）。在正常受试者中，4种测试方案的VO 2与做功率的比值（以斜率表示）相似。然而，在冠状动脉疾病患者中，ACIP和改良ACIP方案的斜率分别为0.84和0.83，而Brace和Cornell方案的斜率分别为0.61和0.71。使用ACIP、改良ACIP和Brace方案分别在93.8%、87.5%和100%的冠状动脉疾病患者中检测到缺血性ST段压低，使用Cornell方案检测到缺血性ST段压低的患者为62.5%。总之，ACIP和改良的ACIP跑步机方案导致阶段之间工作负荷的稳定和适度增加，导致心率和VO 2的线性增加，呼气峰参数与布鲁斯方案相似。
The Asymptomatic Cardiac Ischemia Pilot (ACIP) and modified ACIP treadmill exercise protocols were developed to test patients with coronary artery disease and to linearly increase work load between stages. The physiologic changes that occurred with ACIP and modified ACIP were compared to those with the Bruce and Cornell protocols in 28 normal subjects and 16 men with coronary artery disease. The exercise protocols were randomly assigned over 2 days, and gas exchange data were obtained continuously with each test. In normal subjects, the peak heart rate, systolic blood pressure, peak oxygen consumption rate (VO2) and minute ventilation were similar for the 4 protocols tested, with exercise time shortest for the Bruce protocol in comparison with the ACIP, modified ACIP and Cornell protocols (10.2 ± 3.1 vs 13.4 ± 4.9, 13.9 ± 4.5, and 15.0 ± 4.2 minutes, respectively; p < 0.001). The difference between predicted and observed VO2was smallest for the ACIP protocol (37.0 ± 11.0 vs 35.8 ± 13.5 ml/kg/min) and greatest for the Brace protocol (41.1 ± 11.8 vs 36.7 ± 15.0 ml/ kg/min) in normal subjects, as well as in patients with coronary artery disease (ACIP protocol 26.9 ± 7.1 vs 22.5 ± 6.7, and Brace protocol 29.1 ± 7 vs 22.6 ± 5.7 ml/kg/min, respectively). The ratio of VO2to work rate, expressed as a slope, was similar in normal subjects for the 4 protocols tested. However, in patients with coronary artery disease, the slope was 0.84 and 0.83 for the ACIP and modified ACIP protocols, respectively, versus 0.61 and 0.71 for the Brace and Cornell protocols, respectively. Ischemic ST-segment depression was detected in 93.8, 87.5 and 100% of patients with coronary artery disease using the ACIP, modified ACIP and Brace protocols, respectively, and in 62.5% using the Cornell protocol. In conclusion, the ACIP and modified ACIP treadmill protocols result in a steady and moderate increase in work load between stages, resulting in linear increments in heart rate and VO2, with similar peak expired gas parameters to those of the Bruce protocol.