COMPLICATIONS OF MAXIMAL TREADMILL EXERCISE IN APPARENTLY NORMAL SUBJECTS

在明显正常的受试者中进行最大跑步机锻炼的并发症

• 批准号: 3823184
• 负责人: J L FLEG
• 金额: --
• 依托单位: NATIONAL INSTITUTE ON AGING
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3823184
• 关键词: aging; angina pectoris; blood pressure; bradycardia; cardiovascular disorder epidemiology; cardiovascular stress test; electrocardiography; heart disorder diagnosis; heart rate; human middle age (35-64); human old age (65+); human subject; hypotension; longitudinal human study; myocardial infarction; myocardial ischemia /hypoxia; stress; sudden cardiac death; syncope; tachycardia

We have assessed the prevalence of exercise-induced ventricular tachycardia, exercise-induced supraventricular tachycardia and post-exercise hypotension in BLSA volunteers without clinical evidence of heart disease. Out of 925 subjects undergoing maximal treadmill exercise between September, 1977 and December 1983, 10 subjects (1.2%) developed nonsustained ventricular tachycardia (VT) during or after exercise. Episodes varied in length from 3 to 6 beats and were near associated with symptoms. The prevalence of VT was 3.8% in subjects aged 65 and older. Over a follow-up period averaging 2.0 years, no subject with exercise-induced VT developed syncope, pre-syncope, angina, myocardial infarction or sudden death. Exercise-induced supraventricular tachycardia (SVT) occurred in 50 subjects (5.3%). All episodes were paroxysmal atrial tachycardia; heart rate varied from 120 to 250 bpm (x- = 175 plus/minus 40). Of the 70 episodes of SVT, only 12 were greater than or equal to 10 beats in length; 4 of these were associated with symptoms. The prevalence of SVT was 12.7% in the 245 subjects greater than or equal to 65 years old but only 2.7% in those less than 65 years. An ischemic ST segment response to exercise occurred in 14% of subjects. Hypotension following treadmill exercise, defined by a fall in systolic blood pressure (SBP) at least 20 mm Hg below sitting pre-exercise level to a value less than 90 mm Hg, occurred in 15 subjects (1.7%) with a mean age of 44.2 years. Bradycardia was associated with hypotension in only 2 subjects. When compared with age-matched controls, hypotensive subjects had higher maximal heart rates (183.9 plus/minus 14.7 vs 173.1 plus/minus 11.2 bpm) but no difference in SBP at submaximal or maximal effort. Post-exercise ST segment abnormalities suggestive of myocardial ischemia occurred in one-third of the hypotensive subjects but none of the controls, p less than .05.

我们已经评估了运动诱发的心室肌功能不全的患病率， 心动过速、运动诱发的室上性心动过速和 BLSA志愿者的运动后低血压，无临床证据 心脏病 在925名受试者中， 1977年9月和1983年12月，10名受试者（1.2%） 运动期间或运动后的非持续性室性心动过速（VT）。 发作时间从3次到6次不等， 症状 65岁及以上受试者的VT患病率为3.8%。 在平均2.0年的随访期内，无受试者 运动性室性心动过速发生晕厥、晕厥前期、心绞痛、心肌梗死 梗塞或猝死。 在50名受试者中发生了心动过速（SVT (5.3%). 所有发作均为阵发性房性心动过速;心率各不相同 120 - 250 bpm（x- = 175 +/-40）。 在70次室上性心动过速中， 只有12个大于或等于10次搏动的长度;其中4个 与症状有关。 245例中室上性心动过速的患病率为12.7 大于或等于65岁的受试者，但小于65岁的受试者中仅2.7% 超过65年。 14%的患者出现运动引起的缺血性ST段反应 的主题。 跑步机运动后低血压，定义为收缩压下降 血压（SBP）至少低于运动前坐位水平20 mm Hg， 15例受试者（1.7%）的平均年龄小于90 mmHg 44.2岁 心动过缓与低血压仅2例相关 科目 与年龄匹配的对照组相比， 最大心率较高（183.9 ± 14.7 vs 173.1 ± 14.7 11.2但次最大或最大努力时SBP无差异。 运动后ST段异常提示心肌缺血 在三分之一的强迫症受试者中发生，但在对照组中没有发生， p小于0.05。