Subendocardial ischemia without coronary artery disease: is elevated left ventricular end diastolic pressure the culprit?
Subendocardial ischemia without coronary artery disease: is elevated left ventricular end diastolic pressure the culprit?
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DOI：
10.1185/030079904125003359
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发表时间：
2004-05-01
影响因子：
2.3
通讯作者：
Fazal, H
中科院分区：
文献类型：
--
作者：
Elhabyan, AK;Reyes, BJ;Fazal, H
背景资料：目的是研究左室舒张末期压（LVEDP）升高与心肌缺血的关系。方法：对2002年1月至9月期间收治的1846例胸痛、负荷试验和冠状动脉造影的连续患者进行回顾性病历分析。1592例患者因冠状动脉造影阳性而被排除，254例患者的冠状动脉造影结果与非显著性CAD一致，射血分数> 45%;应激试验阳性210例（82.7%），阴性44例（17.3%）。研究组的平均LVEDP值（11.8 ± 6.1 mmHg）显著高于对照组的平均LVEDP值（7.8 ± 4.6 mmHg）（p < 0.001）。此外，研究组LVEDP异常（≥ 12 mmHg）的人数（n = 103，49.05%）多于对照组（n = 10，22.73%）（p < 0.001）。此外，逻辑回归的结果显示，异常LVEDP值的患者有11倍更有可能有一个积极的压力test.Conclusions：似乎是一个积极的关联之间升高LVEDP和subendocardial缺血，表现为积极的压力测试在没有证据的患者显着的CAD。
Background: The aim was to investigate the association between elevated left ventricular end diastolic pressure (LVEDP) and subendocardial ischemia.Methods: A retrospective chart review was performed of 1846 consecutive patients admitted between January and September 2002 who had chest pain, stress testing and coronary angiography.Results: 1592 patients were excluded due to a positive coronary angiogram for coronary artery disease (CAD), 254 patients had an angiogram compatible with non-significant CAD and an ejection fraction > 45%; of whom 210 (82.7%) had a positive stress test (study group) and the others 44 (17.3%) had a negative stress test (control group). The mean LVEDP value for the study group (11.8 +/- 6.1 mmHg) was significantly higher than the mean LVEDP value for the control group (7.8 +/- 4.6 mmHg) (p < 0.001). In addition, there were more people with abnormal LVEDP ( greater than or equal to 12 mmHg) in the study group (n = 103, 49.05%) compared with the control group (n = 10, 22.73%) (p < 0.001). Furthermore, the results of logistic regression revealed that patients with abnormal LVEDP values were 11 times more likely to have had a positive stress test.Conclusions: There appears to be a positive association between elevated LVEDP and subendocardial ischemia that manifests as a positive stress test in patients without evidence of significant CAD.