POST STRESS LEFT VENTRICULAR CONTRACTILE DYSFUNCTION

应激时局部收缩与血流灌注的关系 缺血性和非缺血性心肌应激后15至45分钟 区域 我们希望确定应激诱导的MBF变化有多快， 停止应激后收缩功能减退。 为此 10例正常志愿者和7例冠心病患者，静息左室功能正常 功能（平均LVEF=50+/-6%）。 所有7例患者均显示 应力诱发的室壁运动异常（WMA）。 17名受试者接受了 门控血池（GBP）和O-15正电子发射断层扫描（PET） 水 GBP和PET图像采集在休息，在应力（仰卧 自行车运动或多巴酚丁胺），以及应激后约15- 45分钟。 CAD患者还接受了负荷铊（Tl）造影，数据如下： 每例受试者在9个地区进行分析。 负荷T1时的所有缺血区域 也表现出应激诱导的WMA。 然而，没有一个异常的 区域表现出应激后持续性功能障碍。 平均绝对 根据动态O-15水数据计算的区域MBF（ml/min/g） 跟随. CAD患者 休息 应力 15分钟后 30分钟后 缺血性 0.90+/-0.08 1.25+/-0.14* 0.99+/-0.05 0.90+/-0.07 诺尼施 1.03+/-0.07 1.79+/-0.18** 1.10+/-0.08 1.08+/-0.09 正常志愿者 正常 0.95+/-0.08 2.10+/-0.31** 1.17+/-0.15 1.00+/-0.08 *p<0.05和 **p<0.01，休息vs应激 静息时缺血区、非缺血区和正常区的MBF相似。 随着应激，正常和非缺血区域的MBF增加了122%， 73%，而缺血区域MBF的增加分别为 减毒（38%）。 MBF在应激后15分钟和30分钟恢复到基线水平 在所有组中。 这些初步数据表明，在CAD患者中， 正常静息LV功能、应激诱导灌注和WMA恢复 在压力终止后迅速恢复到基线。

Relation Between Regional Contraction and Perfusion During Stress and 15 to 45 Minutes After Stress in Ischemic and Nonischemic Myocardial Regions We wished to determine how quickly stress-induced changes in MBF and contractile function subsided following cessation of stress. For this purpose, 10 normal volunteers and 7 pts with CAD and normal resting LV function (mean LVEF=50+/-6%) were studied. All 7 pts exhibited stress-induced wall motion abnormality (WMA). The 17 subjects underwent gated blood pool (GBP) and positron emission tomography (PET) with O-15 water. GBP and PET images were acquired at rest, during stress (supine bicycle exercise or dobutamine), and approximately 15-45min post-stress. CAD pts also underwent stress thallium (Tl) scintigraphy and data were analyzed in 9 regions per subject. All ischemic regions on stress Tl also exhibited stress-induced WMA. However, none of the abnormal regions exhibited post-stress persistent dysfunction. Mean absolute regional MBF (ml/min/g) computed from the dynamic O-15 water data follow. CAD pts rest stress 15min-post 30min-post ischemic 0.90+/-0.08 1.25+/-0.14* 0.99+/-0.05 0.90+/-0.07 nonisch 1.03+/-0.07 1.79+/-0.18** 1.10+/-0.08 1.08+/-0.09 Normal volunteers normal 0.95+/-0.08 2.10+/-0.31** 1.17+/-0.15 1.00+/-0.08 *p<0.05 and **p<0.01, rest vs stress MBF was similar in ischemic, nonischemic and normal regions at rest. With stress, MBF increased in normal and nonischemic regions by 122% and 73%, respectively while the increase in MBF in the ischemic regions was attenuated (38%). MBF returned to baseline 15min and 30min post-stress in all groups. These preliminary data suggest that in pts with CAD and normal resting LV function, stress-induced perfusion and WMAs return quickly to baseline after the termination of stress.