Treadmill performance and cardiac function in selected patients with coronary heart disease.
Treadmill performance and cardiac function in selected patients with coronary heart disease.
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选定的冠心病患者的跑步机性能和心功能。
DOI：
10.1016/s0735-1097(84)80008-x
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发表时间：
1984
影响因子：
24
通讯作者：
Froelicher,VF
中科院分区：
文献类型：
--
作者：
McKirnan,MD;Sullivan,M;Jensen,D;Froelicher,VF
为了调查能够运动至意志疲劳的患者在跑步机上表现的心脏决定因素，对 88 名无心绞痛的冠心病患者进行了测试。运动测试包括仰卧自行车放射性核素心室造影、铊闪烁扫描和带有呼出气体分析的跑步机测试。异常 Q 波位置的数量、射血分数、舒张末期容积、心输出量、运动引起的 ST 段压低以及铊疤痕和缺血评分是考虑的心脏变量。休息和运动射血分数与铊疤痕评分高度相关（r = -0.72 至 -0.75，p < 0.001），但与最大耗氧量无关（r = 0.19 至 0.25，p < 0.05）。预测跑步时间或估计最大耗氧量的变异性中有 55% 是由跑步机测试引起的心率 (39%)、铊缺血评分 (12%) 和静息心输出量 (4%) 的变化来解释的。跑步机测试引起的心率变化只能解释测量最大耗氧量变异性的 27%。心肌损伤可预测静息时的射血分数，而通过跑步机运动提高心率的能力似乎是运动能力的重要组成部分。运动能力仅受无症状缺血的影响很小，并且相对独立于心室功能。
To investigate the cardiac determinants of treadmill performance in patients able to exercise to volitional fatigue, 88 patients with coronary heart disease free of angina pectoris were tested. The exercise tests included supine bicycle radionuclide ventriculography, thallium scintigraphy and treadmill testing with expired gas analysis. The number of abnormal Q wave locations, ejection fraction, end-diastolic volume, cardiac output, exercise-induced ST segment depression and thallium scar and ischemia scores were the cardiac variables considered. Rest and exercise ejection fractions were highly correlated to thallium scar score (r = −0.72 to −0.75, p < 0.001), but not to maximal oxygen consumption (r = 0.19 to 0.25, p < 0.05). Fifty-five percent of the variability in predicting treadmill time or estimated maximal oxygen consumption was explained by treadmill test-induced change in heart rate (39%), thallium ischemia score (12%) and cardiac output at rest (4%). The change in heart rate induced by the treadmill test explained only 27% of the variability in measured maximal oxygen consumption.Myocardial damage predicted ejection fraction at rest and the ability to increase heart rate with treadmill exercise appeared as an essential component of exercise capacity. Exercise capacity was only minimally affected by asymptomatic ischemia and was relatively independent of ventricular function.