増加した運動ダイアストリック血圧は,左心室不全の指標として,不全性左心室機能不全を示す
Lancet (London, England)
|April 13, 1991
まとめ
運動テスト中にダイアストリック血圧の上昇は,冠動脈疾患を示す可能性があります. この異常な反応は,そうでなければ偽陰性結果を受け取る可能性のある高リスク患者を特定することができます.
科学分野:
- 心臓病学 心臓病学
- 運動生理学 運動生理学
背景:
- 胸痛と心筋梗塞 (MI) の評価には,しばしば運動テストが含まれます.
- 運動ストレステスト中の異常な反応は,潜在的心血管問題を示す可能性があります.
研究 の 目的:
- 疑わしいまたは最近の心筋梗塞の患者における運動テスト中に静脈動脈血圧 (DBP) の上昇の重要性を調査する.
- 異常なDBP反応が冠動脈疾患と関連し,介入後の心臓機能に影響を与えるかどうかを判断する.
主な方法:
- 541人の患者の分析で,胸の痛みやMI後の症状限定トレッドミール検査を受けた.
- DBP応答と心電図 (ECG) の不血症と冠動脈血管検査の相関.
- 冠動脈バイパス手術 (CABG) 後の左心室射出分数 (LVEF) 変化の評価は,術後のDBP応答に基づいて行われます.
主要な成果:
- 患者の16.8% (91/541) は,運動中にDBPが>15mmHg上昇した.
- 異常なDBP応答を有する患者のうち,ECGで有意なST抑うつがないにもかかわらず,24人が有意な冠動脈狭窄症 (≥70%で≥2の血管) を有していた.
- 術後のDBP応答が正常であった患者は,CABG後にLVEFが改善したことを示し,不正常なDBP応答が持続した患者とは違いました.
結論:
- 運動中にDBPの異常な上昇は,重大な冠動脈疾患のマーカーである可能性があり,特に診断できないECGの変化を有する患者の場合です.
- この異常な反応により,心筋梗塞のリスクが高い患者が特定され,そうでなければ過小評価される可能性がある.
- DBPの運動への反応は,潜在的に価値のある,心不全の非侵襲的指標であり,予後です.
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