Temporal relation between left ventricular dysfunction and chest pain in coronary artery disease during activities of daily living.
Temporal relation between left ventricular dysfunction and chest pain in coronary artery disease during activities of daily living.
复制标题
日常生活活动期间冠状动脉疾病中左心室功能障碍与胸痛之间的时间关系。
DOI：
10.1016/0002-9149(90)90533-7
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发表时间：
1990
期刊：
影响因子：
--
通讯作者：
Strauss,HW
中科院分区：
文献类型：
--
作者：
Taki,J;Yasuda,T;Tamaki,N;Flamm,SD;Hutter,A;Gold,HK;Leinbach,R;Strauss,HW
Forty-three ambulatory patients with angina of increasing frequency underwent continuous monitoring of left ventricular (LV) function for an average of 2.9 ± 1.9 hours to determine the incidence and temporal sequence of LV dysfunction, ST-segment depression and chest pain. Indicators of ischemia were: a decrease in ejection fraction >5% lasting >1 minute; horizontal or downsloping ST-segment depression of >- 1 mm; or onset of the patient's typical chest pain complex, or a combination of these. During the monitoring interval, subjects performed daily activities such as sitting, walking, climbing stairs and eating. In 11 patients, 22 episodes of chest pain or ST-segment depression, or both, were observed. Eighteen episodes were accompanied by a decrease in ejection fraction (9 patients); chest pain accompanied the decrease in ejection fraction during 13 episodes, whereas ST-segment changes occurred during 7. In 12 of 13 episodes the decrease in ejection fraction began earlier than the onset of chest pain, whereas in 1 patient ejection fraction decrease and chest pain onset started at the same time. The average interval from a decrease in ejection fraction to the onset of chest pain was 56 ± 41 seconds (range 0 to 120). ST changes occurred after the onset of a decrease in ejection fraction in 6 of 7 episodes. The average interval from the onset of ejection fraction decrease and the onset of ST change was 99 ± 91 seconds. These data suggest that LV dysfunction manifested by a decrease in ejection fraction is an earlier indicator of myocardial ischemia than is angina pectoris or electrocardiographic evidence of ischemia.
