PROGNOSTIC IMPLICATIONS OF 'SILENT' VS SYMPTOMATIC MYOCARDIAL ISCHEMIA

轻度冠脉病变患者运动性脑缺血 动脉疾病确定左主干高可能性的亚组 疾病、三支血管病变和随后治疗中的猝死。 许多这样的患者在运动过程中没有胸痛，尽管有客观的原因 缺血的证据。来确定“沉默”的预后含义 我们连续研究了131名轻度或无运动的脑缺血患者。 症状和运动对静息左心功能的保护 心电图和放射性核素血管造影术。因运动而出现心绞痛的患者 可逆性心肌缺血的患病率和严重程度更高。 然而，那些对应激表现为缺血反应的患者 相似的左主干或三支病变的患病率和相似的死亡率 在药物治疗期间的比率，无论是否发生胸痛 锻炼身体。因此，无症状患者与有症状患者的预后 运动测试过程中的缺血情况也类似。

Exercise-induced ischemia in mildly symptomatic patients with coronary artery disease identifies a subgroup with a high likelihood of left main disease, 3-vessel disease, and sudden death during subsequent therapy. Many such patients have no chest pain during exercise despite objective evidence of ischemia. To determine the prognostic implications of "silent" ischemia with exercise, we studied 131 consecutive patients with mild or no symptoms and with preserved resting left ventricular function by exercise ECG and radionuclide angiography. Patients developing angina with exercise had a greater prevalence and severity of reversible myocardial ischemia. However, those patients manifesting an ischemic response to stress had similar prevalence of left main or 3-vessel disease and a similar mortality rate during medical therapy whether or not chest pain developed with exercise. Thus, the prognosis in patients with "silent" vs symptomatic ischemia during exercise testing is similar.