Response of Left Ventricular Volume to Exercise in Man Assessed by Radionuclide Equilibrium Angiography
Response of Left Ventricular Volume to Exercise in Man Assessed by Radionuclide Equilibrium Angiography
复制标题
通过放射性核素平衡血管造影评估男性左心室容积对运动的反应
DOI：
10.1161/01.cir.60.3.565
复制
发表时间：
1979
期刊：
影响因子：
37.8
通讯作者：
W. Ashburn
中科院分区：
文献类型：
--
作者：
R. Slutsky;J. Karliner;D. Ricci;G. Schuler;M. Pfisterer;K. Peterson;W. Ashburn
为了评估运动对左心室容积的影响，我们研究了10名正常男性，15名在运动过程中发生心绞痛的冠心病患者，以及10名在运动过程中没有发生心绞痛的已知冠心病患者。每名受试者在移动的单晶闪烁照相机下进行仰卧自行车运动，直到发生心绞痛或疲劳。结合人血清白蛋白的锝-99m是显像剂。在休息时和每个3分钟运动阶段的最后2分钟以及运动后10分钟收集数据。通过一种新的放射性核素技术来计算，该技术与电影血管造影术具有良好的相关性，并以无量纲单位表示。在正常人中，静息时和运动峰值时的舒张末期容积（EDV）无差异：15.8 ± 6.1（SD）vs 15.2 ± 7（NS）。收缩末期容积（ESV）由5.6 ± 2.9降至2.6 ± 1.6（P < 0.01）。在30个运动周期中，除两个外，ESV均呈进行性下降。心绞痛患者在静息时和胸痛时EDV均大于正常人（p <0.01）。心绞痛患者胸痛时ESV从10.9 ± 6.7增加到14.2 ± 7.5（p < 0.001），导致射血分数（EF）降低（0.57 ± 0.15到0.45 ± 0.16，p < 0.001）。所有心绞痛患者在胸痛时的ESV均高于胸痛前的运动阶段。作为一个组，未发生心绞痛的患者在静息和运动峰值时的EDV低于发生心绞痛的患者：分别为14.8 vs 23.5（p < 0.01）和13.7 vs 23.5（p < 0.01）。ESV从静息时的8.1 ± 4.1变为峰值运动时的7.3 ± 5.3，EF从0.45 ± 0.12变为0.50 ± 0.16（均为NS）。我们得出结论：运动时EF增加是由于ESV降低;心绞痛患者的EF降低是由于ESV增加;无心绞痛的冠心病患者的EF无变化，因为ESV无显著变化。放射性核素平衡血管造影术可用于评估冠状动脉疾病患者的EF和容积变化。
To assess the effects of exercise on left ventricular volumes we studied 10 normal men, 15 patients with coronary disease who developed angina pectoris during exercise, and 10 patients with known coronary disease who did not develop angina during exercise. Each subject performed supine bicycle exercise under a mobile, single-crystal scintillation camera until angina or fatigue occurred. Technetium-99m bound to human serum albumin was the imaging agent. Data were collected at rest and during the last 2 minutes of each 3-minute stage of exercise and for 10 minutes after exercise. Volumes were calculated by a new radionuclide technique that correlates well with cineangiography and is expressed in nondimensional units. In normal subjects, the end-diastolic volume (EDV) at rest was not different from that at peak exercise: 15.8 ± 6.1 (SD) vs 15.2 ± 7 (NS). The end-systolic volume (ESV) decreased from 5.6 ± 2.9 to 2.6 ± 1.6 at peak exercise (p < 0.01). ESV decreased progressively in all but two of 30 exercise periods. Angina patients had a larger EDV (p < 0.01) at rest and during chest pain (p < 0.01) than normals. Angina patients increased their ESV from 10.9 ± 6.7 to 14.2 ± 7.5 during chest pain (p < 0.001), resulting in a decreased ejection fraction (EF) (0.57 ± 0.15 to 0.45 ± 0.16, p < 0.001). All angina patients had a higher ESV during chest pain than during the exercise stage before chest pain. As a group, patients who did not develop angina had a lower EDV at rest and peak exercise than those who did develop angina: 14.8 vs 23.5 (p < 0.01) and 13.7 vs 23.5 (p < 0.01), respectively. The ESV went from 8.1 ± 4.1 at rest to 7.3 ± 5.3 at peak exercise, and the EF from 0.45 ± 0.12 to 0.50 ± 0.16 (all NS). We conclude: that the EF increases during exercise due to a decrease in ESV; that the EF in patients with angina decreases because of an increase in ESV; and that the EF in coronary disease patients without angina shows no change because there is no significant change in the ESV. Radionuclide equilibrium angiography may prove useful for assessing EF and volume changes in patients with coronary artery disease.