Relation of Heart Rate and Systolic Blood Pressure to the Onset of Pain in Angina Pectoris
Relation of Heart Rate and Systolic Blood Pressure to the Onset of Pain in Angina Pectoris
复制标题
心率和收缩压与心绞痛疼痛发作的关系
作者：
BRIAN F. Robinson
直接、连续记录15例心绞痛患者的动脉压，同时反复进行不同类型、不同程度的运动引起疼痛。在每一种情况下，心绞痛的沉淀可能始终与心率和收缩压的乘积所达到的水平相关（必要时因射血时间的变化而纠正）。即使在运动的类型、强度和持续时间有很大的变化时，这种关系仍然存在，并且在观察到自发性和情绪性疼痛发作的患者中也保持不变。一名患者的运动耐受性有了实质性的改善，这完全是由于运动后循环反应的减少。结论是，心绞痛的沉淀通常是心肌工作上升到一个临界水平的结果，这在每个病人身上基本上是固定的。在不同场合引起疼痛的不同程度通常可以用循环系统对突发压力的不同反应来解释。
Arterial pressure was recorded directly and continuously in 15 patients with angina pectoris while pain was repeatedly induced by exercise of various types and severity. In every case, the precipitation of angina could be consistently related to the level reached by the product of heart rate and systolic blood pressure (corrected when necessary for changes in ejection time). This relationship persisted even when there were large variations in the type, intensity, and duration of the exercise and was also maintained in a patient in whom spontaneous and emotional episodes of pain were observed. A substantial improvement in exercise tolerance occurred in one patient and this was completely accounted for by a reduction in the circulatory response to exercise.It was concluded that the precipitation of angina is normally the result of a rise in the work of the myocardium to a critical level which is essentially fixed in each patient. The varying ease with which pain is provoked on different occasions can usually be explained by variations in circulatory response to the precipitating stress.