Impact of echocardiographic left ventricular mass on mechanistic implications of exercise testing parameters.
Impact of echocardiographic left ventricular mass on mechanistic implications of exercise testing parameters.
复制标题
超声心动图左心室质量对运动测试参数机械意义的影响。
DOI：
10.1016/s0002-9149(99)80268-9
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
D. Levy
中科院分区：
文献类型：
--
作者：
Michael S. Lauer;Michael S. Lauer;P. Okin;P. Okin;K. Anderson;K. Anderson;D. Levy;D. Levy
心电图左心室（LV）肥大长期以来一直被认为与运动异常ST段反应相关;这种相关性被认为是假阳性结果。有一个与超声心动图左室质量运动ST段反应和其他运动参数的数据匮乏。作为常规评估的一部分，来自心脏研究的1,408名男性和1,618名女性无临床心脏疾病，在同一诊所访视时根据布鲁斯方案进行超声心动图和运动平板试验。通过标准标准和ΔT/心率指数定义异常ST段反应。通过M型超声心动图计算LV质量。超声心动图左心室肥大与异常ΔST/心率指数相关（男性，比值比[OR] 1.78，95%置信区间[CI] 1.05 - 3.01，p = 0.03;女性，OR 2.13，95% CI 1.31 - 3.44，p = 0.002），但根据标准标准，与异常反应无关。超声心动图左心室肥大也与达到年龄预测目标心率的可能性较低相关（男性，OR 0.45，95% CI 0.31 - 0.65，p < 0.001;女性，OR 0.53，95% CI 0.37 - 0.76，p < 0.001）和运动能力较低。尽管存在这些相关性，超声心动图左室肥厚与较高的峰值心率-收缩压双乘积相关。总之，超声心动图左心室肥大与ST段反应异常、达到目标心率的可能性降低、运动能力降低和反映心肌需氧量的双乘积增加相关。
Electrocardiographic left ventricular (LV) hypertrophy has long been known to be associated with an abnormal ST-segment response to exercise; this association has been considered to represent a false-positive finding. There is a paucity of data relating echocardiographic LV mass to exercise ST-segment responses and other exercise parameters. As part of a routine evaluation, 1,408 men and 1,618 women from the Framingham Heart Study who were free of clinical cardiac disease underwent echocardiography and exercise treadmill testing according to the Bruce protocol at the same clinic visit. Abnormal ST-segment responses were defined both by standard criteria and the ΔT/heart rate index. LV mass was calculated from M-mode echocardiography. Echocardiographic LV hypertrophy was associated with an abnormal ΔST/heart rate index (in men, odds ratio [OR] 1.78, 95% confidence interval [CI] 1.05 to 3.01, p = 0.03; in women, OR 2.13, 95% CI 1.31 to 3.44, p = 0.002) but not with an abnormal response according to standard criteria. Echocardiographic LV hypertrophy was also associated with a lower likelihood of achieving an age-predicted target heart rate (in men, OR 0.45, 95% CI 0.31 to 0.65, p < 0.001; in women, OR 0.53, 95% CI 0.37 to 0.76, p < 0.001) and with a lower exercise capacity. Despite these associations, echocardiographic LV hypertrophy was associated with a higher peak heart rate-systolic blood pressure double product. In conclusion, echocardiographic LV hypertrophy is associated with an abnormal ST-segment response, a lower likelihood of achieving target heart rate, decreased exercise capacity, and an increased double product, which is a reflection of myocardial oxygen demand.