运动试验早期心率快速增加的临床意义

Clinical significance of rapid increase of heart rate at onset of treadmill exercise test

目的:探讨心电图平板运动试验早期心率的快速增加与冠状动脉(冠脉)病变的关系。方法:选择245例进行了心电图平板运动试验与冠状动脉造影的胸痛患者,根据冠脉造影结果,分为冠心病组和非冠心病组,冠心病组中又进一步分为单支病变、双支病变及三支病变组,对比分析各组平板运动试验开始后第1分钟心率的增加量(ΔHR1minute)。结果:冠心病组ΔHR1minute明显高于非冠心病组(P<0.01);随着冠脉病变严重度的增加,ΔHR1minute逐渐增大,组间差异均有显著性(P<0.05);相关分析显示ΔHR1minute与ST段压低值及冠脉病变严重度均呈正相关(r=0.252,0.470,P<0.01)。结论:冠心病患者ΔHR1minute增大,ΔHR1minute可作为反映心肌缺血及冠脉病变程度的指标之一。

Objective To analyze the correlation between rapid increase of heart rate at onset of electrocardiogram treadmill exercise test and coronary artery lesion. Methods We selected 245 patients who underwent electrocardiogram treadmill exercise and coronary angiography. The patients were divided into a coronary heart disease （CHD） group and a non-CHD group according to the results of coronary angiography. The patients of the CHD group were divided into a single-vessel disease group, a double-vessel disease group, and a triplet-vessel disease group. The increased heart rate during the first minute （ △HR1minute ） of treadmill exercise test and the extent of coronary artery lesion were analyzed. Results △HR1minute in the CHD group was significantly higher than that in the non-CHD group（ P 〈 0.01 ）. △HR1minute had an increasing trend with the severity of coronary artery lesion. △HR1minute was positively correlated to the depression of ST segment and the severity of coronary artery lesion （ r = 0. 252,0. 470, P 〈 0. 01 ）. Conclusion Patients with CHD have an increased △HR1minute.△HR1minute can be one of the indexes to estimate the extent of myocardial ischemia and coronary artery lesion.