MECHANISMS OF AMBULATORY ISCHEMIA IN CORONARY DISEASE

稳定型冠状动脉疾病患者可能会发生以下事件： 日常生活中的心肌缺血。的作用机制 这些事件的发生并不清楚。调查这一 我们对54例稳定型心绞痛患者进行了动态心电图监测， 冠状动脉疾病和运动试验阳性缺血阈值 从运动试验中测量，作为开始时的心率， ST段压低心率的增加先于绝大多数 (89%）。发作次数 与缺血阈值显著相关， 随着患者达到缺血阈值的次数 在监测期间。这些发现表明， 心肌缺血发作的发生机制 冠状动脉疾病患者的生活是心肌的增加， 氧气需求，如心率的增加所证明的。的频率 在日常生活中心肌缺血的发作是由 白天达到缺血阈值的频率。

Patients with stable coronary artery disease may experience episodes of myocardial ischemia during daily life. The mechanisms underlying the occurrence of these episodes are not well understood. To investigate this issue, we performed ambulatory ECG monitoring in 54 patients with stable coronary artery disease and positive exercise test. The ischemic threshold was measured from the exercise test as heart rate at the onset of ST-segment depression. An increase in heart rate preceded the vast majority (89%) of the ischemic episodes during monitoring. The number of episodes significantly correlated with ischemic threshold, and even more strongly with the number of times that the patients achieved ischemic threshold during monitoring. These findings indicate that the most important mechanism in the genesis of episodes of myocardial ischemia during daily life in patients with coronary artery disease is the increase in myocardial oxygen demands as evidenced by the increase in heart rate. The frequency of episodes of myocardial ischemia during daily life is determined by the frequency with which the ischemic threshold is reached during the day.