Improved myocardial function during exercise after successful percutaneous transluminal coronary angioplasty.
Improved myocardial function during exercise after successful percutaneous transluminal coronary angioplasty.
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成功经皮腔内冠状动脉成形术后运动期间心肌功能得到改善。
DOI：
10.1056/nejm198202253060801
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发表时间：
1982
期刊：
影响因子：
--
通讯作者：
S. Epstein
中科院分区：
文献类型：
--
作者：
K. Kent;R. Bonow;D. Rosing;C. Ewels;L. C. Lipson;C. Mcintosh;S. Bacharach;Michael J. Green;S. Epstein
连续59例接受经皮冠状动脉腔内成形术的冠状动脉疾病患者，在血管成形术前（如可能）和血管成形术成功后，在静息和运动时进行放射性核素心室造影。38例患者（64%）的血管造影手术成功。3例（5%）有冠状动脉闭塞并发症。动脉狭窄从74 +/-2%降至31 +/-3%（平均值+/- S.E.M.）。术前静息时平均射血分数为55 +/-2%，运动时为51 +/-3%。血管成形术成功后，静息时射血分数不变，但运动时增加到62 +/-2%（P <0.001）。手术前94%的患者在运动过程中存在区域功能障碍，而成功的血管成形术后仅为8%。在手术成功的38名患者中，19名持续改善超过6个月，8名持续改善3至6个月。11名患者症状复发; 9名患者的第二次血管成形术最初成功。在24名无症状持续6个月的患者中（19名在第一次手术后，5名在第二次手术后），运动期间左心室射血分数保持稳定或改善。
Fifty-nine consecutive patients with coronary-artery disease undergoing percutaneous transluminal coronary angioplasty were evaluated with radionuclide ventriculography at rest and during exercise before angioplasty (when possible) and afterward when it was successful. Thirty-eight patients (64 per cent) had an angiographically successful procedure. Three (5 per cent) had coronary occlusion as a complication. Arterial stenosis was reduced from 74 +/- 2 per cent to 31 +/- 3 per cent (mean +/- S.E.M.). The mean ejection fraction was 55 +/- 2 per cent at rest and 51 +/- 3 per cent during exercise before the procedure. After successful angioplasty, the ejection fraction was unchanged at rest but increased to 62 +/- 2 per cent (P less than 0.001) during exercise. Regional dysfunction was present during exercise in 94 per cent of the patients before the procedure and in only 8 per cent after successful angioplasty. Of the 38 patients in whom the procedure was successful, 19 had sustained improvement for over six months, and eight for three to six months. Eleven patients had recurrence of symptoms; the second angioplasty was initially successful in nine. In 24 patients remaining asymptomatic for six months (19 after the first procedure and five after the second), the left ventricular ejection fraction during exercise remained stable or improved.