CLINICAL SIGNIFICANCE OF SYMPTOMATIC AND SILENT MYOCARDIAL ISCHEMIA DURING EXERCISE TEST IN PATIENTS WITH EFFORT ANGINA PECTORIS : Investigation of Hemodynamic Responses During Supine Ergometer Exercise Test

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Thirty one patients with stable effort angina who had no prior myocardial infarctions underwent symptom-limited ergometer exercise test. Hemodynamic responses during exercise were assessed to determine whether or not the limiting symptoms were related to the severity of exercise-induced myocardial ischemia. Twenty-two subjects (Group I) were limited by angina and nine (Group II) were limited by other symptoms. There were no differences in age, sex distribution, prevalence of diabetes mellitus, and left ventricular ejection fraction between the two groups. Multivessel coronary artery diseases, however, were more frequent in group I (16/22 vs 3/9: p <0.05). Maximal work load (46.6±16.0 vs 62.5±13.4 W: p<0.05), exercise duration (4.7±2.0 vs 7.2±1.4 min: p<0.005), and maximal oxygen consumption (12.4±4.1 vs 19.3±3.3 ml/kg/min: p<0.005) were significantly lower in group I. The magnitude of ST depression was not different between the two groups (2.0±0.8 vs 1.8±0.7 mm:NS). At maximal exercise, heart rate, mean blood pressure, cardiac index, and stroke work index (SWI) were significantly lower in group I (p<0.05) and pulmonary capillary wedge pressure was significantly higher in group I (31.1±6.1 vs 25.1±5.6 mmHg: p<0.05). Stroke volume index and SWI increased significantly in group II (from 42.7±8.8 to 55.0±11.2 ml/m^2: p<0.005, and from 56.8±12.7 to 80.0±12.0 g・m/m^2: p<0.005, respectively), but not in group I (from 46.1±11.8 to 51.1±14.4 ml/m^2: NS, and from 60.3±17.2 to 92.9±19.6 g・m/m^2: NS, respectively). These results indicate that the anginal symptom during exercise test in patients with proven effort angina without myocardial infarction is suggestive of hemodynamically more significant myocardial ischmia.
社団法人日本循環器学会の論文
1989-05-20

CLINICAL SIGNIFICANCE OF SYMPTOMATIC AND SILENT MYOCARDIAL ISCHEMIA DURING EXERCISE TEST IN PATIENTS WITH EFFORT ANGINA PECTORIS : Investigation of Hemodynamic Responses During Supine Ergometer Exercise Test

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