Relationship between Ischemic ST Segment Depression and Left Ventricular Function During Sitting Bicycle Exercise : SYMPOSIUM ON EXERCISE TESTINGS OF HEART DISEASE

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概要

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• Eleven cases with angina of effort and 6 cases with giant negative T wave were subjected to bicycle test in the sitting position to assess the hemodynamic changes as compared with those in 6 control cases. Measurements were made of the mean pulmonary capillary wedge pressure (m-PCP≒LVEDP) as a parameter of left ventricular function and ST segment depression in the electrocardiogram during exercise every minute. In control group, m-PCP increased 3 mmHg (Δm-PCP= 2-4 mmHg) on average, observing a constant value of m-PCP during exercise. In all cases of angina, chest pain was elicited during exercise where there was a progressing increase in m-PCP with a significant difference from control group (p <0.05). In 7 cases of angina, the PCP-LVSWI relationship demonstrated impairment of left ventricular function due to myocardial ischemia. In cases of two or three vessel disease, the increase in m-PCP during exercise was coincident with the onset of ST segment depression in the exercise ECG. There was a high-grade correlationship between the increment in m-PCP and the magnitude of ST segment depression (r= 0.87-0.99). A close correlationship also existed between the magnitude of ST segment depression and the rate-pressure product (r=0.88-0.99). This suggests that the magnitude of ischemic ST segment depression reflects the severity of myocardial ischemia and is also closely related with impaired left ventricular function due to the reduction of contractility and compliance of the heart. The cases of giant negative T wave proved to have a normal pumping function without coronary artery lesions. The increase in m-PCP during exercise was more marked in 5 of 6 these cases than in control group (m-PCP= 5-9 mmHg), probable because of decreased left ventricular compliance due to atypical hypertrophy. The blood pressure during exercise in this group was significantly higher (p<0.05) than in control group, leading to a part of cause for atypical hypertrophy.

• 社団法人日本循環器学会の論文
• 1979-04-20

著者

• Toshima Hironori

  The 3rd Department Of Medicine Kurume University School Of Medicine

• Bekki Hisatoshi

  The 3rd Department of Internal Medicine

• Akiyoshi Toshinori

  The 3rd Intern. Med., Kurume Univ.

• Miki Nobushige

  The 3rd Dept. of Intern. Med., Kurume Univ.

• Furusho Yohzo

  The Third Department Of Internal Medicine Kurume University School Of Medicine

• Itaya Kenichi

  The 3rd Dept. Of Int. Med. Kurume Univ. School Of Med.

• Miki Nobushige

  The Third Department Of Internal Medicine Kurume University School Of Medicine

• Bekki Hisatoshi

  The 3rd Department Of Internal Medicine Kurume University

• Akiyoshi Toshinori

  The 3rd Department Of Internal Medicine Kurume University School Of Medicine

• FURUSHO YOHZO

  The 3rd Department of Internal Medicine, Kurume University School of Medicine

• Itaya Ken-ichi

  3rd Dept. Of Intern. Med. Kurume Univ. School Of Med.

• Bekki Hisatoshi

  Kurume University. School Of Medicine The 3rd Dept. Of Internal Medicine

• Akiyoshi Toshinori

  3rd Dept. Of Intern. Med. Kurume Univ. School Of Med

• Miki Nobushige

  Cardiovascular Research Institute Kurume Univ. School Of Med.

• Miki Nobushige

  The 3rd Dept. Of Intern. Med. Kurume Univ. School Of Med.

• Toshima Hironori

  The 3rd Department Of Internal Medicine Kurume University

• Akiyoshi Toshinori

  3rd Dept.of Intern.med. Kurume Univ.school Of Med.

• Furusho Yozo

  The 3rd Dept. Of Intern. Med. Kurume Univ. School Of Med.

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