运动后收缩压反应对左室肥厚合并冠心病的诊断价值

Diagnostic Value of Postexercise Systolic Blood Pressure Response for Detecting Coronary Artery Disease in Patients with Electrocardiographic Left Ventricular Hypertrophy

目的 探讨运动试验中运动后收缩压反应对左室肥厚合并冠心的诊断价值。方法 5 8例心电图左室肥厚患者根据冠状动脉造影结果分为冠心病组 (31例 )和非冠心病组 (2 7例 ) ,比较两组患者在平板运动试验中收缩压比值 (运动结束后 3min与运动高峰时收缩压比值 )的差异。结果 在冠心病组 ,运动试验中收缩压比值明显高于非冠心病组 (0 98± 0 11vs 0 84± 0 11,P <0 0 1) ;以运动试验中收缩压比值 >0 90且有ST段下移≥0 1mv为标准 ,诊断冠心病的准确性为 82 8% ,明显高于单用ST段下移诊断冠心病的准确性 (6 3 8% ,P <0 0 5 )。结论 在心电图左室肥厚患者 ,运动后收缩压反应是判断冠心病的有用指标 ,结合ST段下移 。

Objective To investigate the diagnostic value of postexercise systolic blood pressure(SBP) response in detecting coronary artery disease(CAD) in patients with electrocardiographic left ventricular(LV) hypertrophy.Methods Acording to their results of selective coronary angiography,58 patients with electrocardiographic LV hypertrophy were divided into group 1(27 patients without significant coronary lesions) and group 2(31 patients with significant coronary lesions).Symptom-limited treadmill exercise testing was conducted in those patients.Results The SBP ratio(SBP at 3 minutes of recovery divided by SBP at peak exercise) was significantly higher in group 2 than in group 1(0 98±0 11 vs 0 84±0 11,P<0 01) .By detecting CAD in patients with electrocardiographic LV hypertrophy,the high SBP ratio(≥0 90) combined with ST-segment depression was significantly more accurate than ST-segment depression alone(the accuracy 82 8% vs 63 8%P<0 05).Conclusion The postexercise SBP response combinated with ST depression can improve the accuracy of treadmill exercise test for detecting CAD in patients with electrocardiographic LV hypertrophy.