Radionuclide imaging correlatives of heart rate impairment during maximal exercise testing.

Radionuclide imaging correlatives of heart rate impairment during maximal exercise testing.
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最大运动测试期间心率损伤的放射性核素成像相关性。

DOI:
10.1016/s0735-1097(83)80228-9
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发表时间:
1983
影响因子:
24
通讯作者:
Froelicher,V
Froelicher,V
中科院分区:
医学1区
文献类型:
--
作者:
Hammond,HK;Kelly,TL;Froelicher,V

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对最大动态运动的心率反应低于正常,称为变时性功能不全或心率受损,已被证明预后不良。为了更好地描述具有这一发现的患者,对156名患有冠心病的男性进行了评估。所有患者均进行了最大运动试验,包括氧耗量,运动心电图,铊造影和放射性核素心室造影的测量。变时性功能不全定义为最大心率低于年龄与两次独立运动试验最大心率回归线的估计值的1个标准误差。在这样定义的患者中,平均最大耗氧量显著降低,心绞痛是停止跑步机运动的主要原因。与心率反应正常的患者相比,不受心绞痛限制的变时性功能不全患者有更多的心肌瘢痕和功能障碍的证据,并且有更高的三支冠状动脉疾病的患病率。放射性核素检测结果表明,在变时性功能不全患者中,心绞痛患者的预后优于无心绞痛但可能有心肌功能不全的患者。
A lower than normal heart rate response to maximal dynamic exercise, known as chronotropic incompetence or heart rate impairment, has been demonstrated to have a poor prognosis. In order to better describe patients with this finding, 156 men with coronary heart disease were evaluated. All patients were studied with maximal exercise testing, including measurements of oxygen consumption, exercise electrocardiograms, thallium scintigraphy and radionuclide ventriculography. Chronotropic incompetence was defined as a maximal heart rate 1 standard error of the estimate below the regression line of age versus maximal heart rate on two separate exercise tests. In patients so defined, mean maximal oxygen consumption was significantly lowered and angina was the major reason for stopping exercise on the treadmill. Patients with chronotropic incompetence not limited by angina had more evidence of myocardial scar and dysfunction and had a greater prevalence of three vessel coronary disease than did patients with a normal heart rate response. Radionuclide testing results suggest that among patients with chronotropic incompetence, those with angina have a better prognosis than those who do not have angina but who may have myocardial dysfunction.
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