运动试验PTFv_1异常与超声心动图A/E的关系及临床意义

Study on the clinical value of the relationship among abnormal PTFVj and ST deviation during bicycle er- gometry, and A/E ratio of left ventricular inflow de- termined by doppler echocardiograph

通过对148例运动试验PTFv_1改变与脉冲多普勒超声心动图A/E关系的对照研究,了解运动试验中出现PTFv_1异常的临床意义.结果在运动试验诱发PTFv_1异常合并ST异常组(n=19)及单纯PTFv_1异常组(n=31)中,超声心动图发生A/E异常者高达94.7%及90.3%,发生率均非常显著高于运动试验正常组(n=50)(P<0.001)及单纯ST异常组(n=48)(P<0.001).提示运动诱发PTFv_1异常与左心室舒张功能障碍有关,可作为早期反映左心室舒张功能异常的心电图指标.

In order to assess the clinical value of screening test for coronary heart disease, bicycle ergometry was carried out in 688 subjects and the results were compared with those determined by Doppler echocardiography. During exercise testing, the incidence of anomaly of ST segment and PTFv1 were correlated ( r = 0. 267) to and overlapped one another as the incidence of PTFv1 anomaly in patients with abnormal ST deviation was significantly higher than that in patients with normal ST segments ( P <0. 001), and vice ver ( P <0. 001). In patients with PTFv1 anomaly induced during exercise testing, the incidence of increased A/E ratio (90. 3%) was significantly higher than that both in patients with normal controls and in patients with abnormal ST segments ( P <0. 001). The results suggest that PTFv1 and ST segments, when observed combiningly during exercise testing, exert an important role in elevating the diagnostic rate in patients with coronary heart disease. Exercise-induced PTFv1 anomaly is closely related to left ventricular diastolic insufficiency, and hence can be used as an electrocardiographic pre-alarming index.