在寒冷环境中运动诱导的心肌缺血. 抗血管性药物的作用
M Juneau1, M Johnstone, E Dempsey
1Department of Medicine, Montreal Heart Institute, Quebec, Canada.
Circulation
|May 1, 1989
概括
暴露于寒冷不会显著影响运动诱导的心肌缺血在大多数稳定性胸痛患者. 然而,对寒冷敏感的个体在寒冷的温度下会更早地经历缺血,尽管抗风脉的药物仍然有效.
科学领域:
- 心脏病学 心脏病学
- 环境生理学环境生理学
背景情况:
- 稳定性心痛和运动诱导的心肌缺血是令人担忧的重大问题.
- 寒冷环境对心血管功能和缺血的影响尚未完全理解.
研究的目的:
- 评估寒冷对患有稳定性胸痛的患者缺血值的影响.
- 在寒冷的环境中评估抗风脉药物的有效性 (propranolol,diltiazem).
主要方法:
- 24名患有稳定性胸痛的患者接受了随机的双盲跑步机测试,在-8°C和20°C的温度下进行.
- 药物包括安慰剂,普罗普兰诺洛尔 (80毫克) 和迪尔提亚泽姆 (120毫克).
- 运动终点,包括时间到1毫米的ST压力被记录下来.
主要成果:
- 在整个安慰剂组中,寒冷和正常温度之间的运动终点没有显著差异.
- 对于感冒敏感的患者显示,与20°C相比,在-8°C时缺血的发病时间显著提前.
- 在两种温度下,propranolol和diltiazem都同样有效地延长了 ischemia 的时间.
- 迪尔蒂亚泽姆,但不是普拉诺洛尔,延长了总体炼时间.
结论:
- 寒冷暴露通常不会在稳定的心脏病患者中恶化缺血值.
- 一个对寒冷敏感的小组患者在寒冷条件下表现出较低的缺血值.
- 对于运动诱导性缺血症,抗性药物如普罗普拉诺洛尔和迪尔蒂亚泽姆在寒冷的环境中保持有效性.
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