EFFECTS OF SUBLINGUAL ISOSORBIDE DINITRATE ON LEFT VENTRICULAR PERFORMANCE DURING EXERCISE IN PATIENTS WITH MYOCARDIAL INFARCTION
スポンサーリンク
概要
- 論文の詳細を見る
In order to investigate left ventricular performance during exercise in patients with myocardial infarction and evaluate the effects of sublingual isosorbide dinitrate (ISDN) on left ventricular performance, we performed a symptom-limited multigraded exercise test using a bicycle ergometer in supine position . Thirty-seven patients with myocardial infarction were evaluated in order to clarify the hemodynamic responses to exercise with and without sublingual ISDN. Patients were subdivided into 3 groups according to the level of pulmonary capillary pressure (PCP) and cardiac index (CI) at peak exercise as follows: Group I (14 patients); PCP < 18 mmHg, CI ≧ 5.0 or CI < 5.0 L/min/m^2, Group II (11 patients); PCP ≧ 18 mmHg, CI ≧ 5.0 L/min/m^2, Group III (12 patients); PCP ≧ 18 mmHg, CI < 5.0 L/min/m^2. Exercise capacity without ISDN (control study) was correlated with left ventricular performance during exercise. Although left ventricular performance in patients who complained of dyspnea or chest pain at peak exercise was worse than those who complained of leg fatigue, we could not predict hemodynamics during exercise from the level of hemodynamic parameters at rest in each patient. Determinant factors of left ventricular performance during exercise were age, previous history of myocardial infarction, the severity of coronary artery lesion and the extent of left ventricular wall motion abnormality which was estimated by left ventriculogram as an index of infarct size. After sublingual ISDN (ISDN study), exercise capacity was improved. No patient terminated exercise because of chest pain and only one did because of dyspnea. While no significant differences in heart rate (HR), mean arterial pressure (MAP) cardiac index (CI), stroke volume index (SVI), left ventricular stroke work index (LVSWI) and systemic vascular resistance (SVR) were observed at peak exercise between the control study and ISDN study in Groups I and II, PCP was lower in the ISDN study than in the control study. On the other hand, CI and LVSWI in Group III increased and SVR significantly decreased at peak exercise. Effects of ISDN on hemodynamics during exercise was well related to the severity of coronary artery lesion and inversely correlated with the infarct size. These results indicate that investigation of hemodynamic response to exercise is a useful method for determination of cardiac rehabilitation program in patients with myocardial infarction and ISDN is an effective drug for the improvement of left ventricular performance during exercise.
- 社団法人日本循環器学会の論文
- 1984-10-20
著者
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Inoue Hiroko
Division Of Cardiology Sakurabashi Watanabe Hospital
-
Minamino Takazo
Department Of Internal Medicine And Therapeutics Osaka University Graduate School Of Medicine
-
Sakai Kei
Heart Science Centre Harefield Hospital Imperial College Faculty Of Medicine
-
Sato Hiroshi
大阪大学 医学系研究科循環器内科学
-
Katoh Osamu
The Division Of Cardiol Sakurabashi Watanabe Hospital
-
Katoh O
Department Of Cellular Biology Research Institute For Radiation Biology And Medicine Hiroshima Unive
-
Katoh Osamu
Division of Cardiovascular Medicine, Toyohashi Heart Center
-
Fujii Kenji
The Division Of Cardiology Sakurabashi Watanabe Hospital
-
Inoue Michitoshi
First Dept, of Med., Osaka Univ. Sch. of Med. and Osaka Keisatsu Hospital
-
Minamino Takazo
Division of Cardiology, Sakurabashi Watanabe Hospital
-
Fukui Sugao
National Cardiovascular Center Research Institute
-
Fukui Sugao
和泉市
-
Fukui Sugao
Division Of Cardiology Kashiwara General Hospital
-
Fukui Sugao
Division Of Cardiology Sakurabashl Watanabe Hospital
-
Higashi Yutaka
Sakurabashi Watanabe Hospital And Ist. Dept. Of Med. Osaka Univ. School Of Med.
-
Hamano Yutaka
Division of Cardiology, Sakurabashi Watanabe Hospital
-
Katoh Osamu
Division Of Cardiovascular Medicine Toyohashi Heart Center
-
Minamino Takazo
Division Of Cardiology Sakurabashi Watanabe Hospital
-
Inoue Hiroko
Division Of Cardiology National Hospital Organization Kyushu Medical Center
-
Sato Hideyuki
First Department Of Medicine Osaka University Medical School
-
SATOH KUNITOMO
Division of Cardiology, Kanoh General Hospital
-
TANAKA TOSHIHIKO
Department of Medicine and Geriatrics, Osaka University, Medical School
-
FUJII KENSHI
First Department of Medicine, Osaka University, Medical School
-
SATOH HIDEYUKI
First Department of Medicine, Osaka University, Medical School
-
Kuki Satoru
First Department Of Surgery Osaka University Medical School
-
Hamano Yutaka
Division Of Cardiology Sakurabashi Watanabe Hospital
-
Hamanaka Yasuhiko
1st Dept Of Medicine Osaka Univ Med Sch
-
Harigae Satoko
Division Of Cardiology Yao Municipal Hospital
-
Tomooka Toshio
The Division Of Cardiology Sakurabashi Watanabe Hospital
-
Sato Kunitomo
Division Of Cardiology Sakurabashi Watanabe Hospital
-
Satoh Kunitomo
Cardiovascular Division Sakurabashi Watanebe Hospital
-
Hoshida Shirou
The Cardiovascular Division Sakurabashi Watanabe Hospital.
-
Hamano Y
The First Dept Of Medicine Osaka University
-
Fukui Sugao
The Division Of Cardiology Sakurabashi Watanabe Hospital
-
Hamano Y
Division Of Cardiology First Department Of Medicine Osaka University School Of Medicine
-
Tanaka Toshihiko
The Division Of Cardiology Sakurabashi Watanabe Hospital
-
Inoue Michitoshi
First Department Of Medicine And Department Of Pathophysiology Osaka University School Of Medicine
-
Tanaka T
The Division Of Cardiology Sakurabashi Watanabe Hospital
-
Kajiya Fumihoko
Dept. Of Medical Engineering And System Cerdiology Kawasaki Medical School.
-
Tanaka Toshihiko
Department Of Dermatology Faculty Of Medicine Hiroshima University
-
Hamano Yutaka
Division Of Cardiology First Department Of Medicine Osaka University School Of Medicine
-
Katoh Osamu
Division Of Cardiology Toyohashi Heart Center
-
INOUE Michitoshi
First Department of Internal Medicine, Osaka University, Medical School
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