Exercise-induced left bundle branch block(EI-LBBB)is infrequent phenomenon.We present two patients with angina pectoris who developed EI-LBBB during exercise tolerance test.The first patient with typical angina pector...Exercise-induced left bundle branch block(EI-LBBB)is infrequent phenomenon.We present two patients with angina pectoris who developed EI-LBBB during exercise tolerance test.The first patient with typical angina pectoris had significant obstructive coronary artery disease(CAD)requiring percutaneous coronary intervention of multiple lesions including placement of drug eluting stents.The second patient had atypical chest pain without signs of CAD at all.EI-LBBB occurred at a heart rate of 80 bpm and 141 bpm in the first and second patient,respectively.EI-LBBB remained visible through the test till the recovery period in the first patient at a heart rate of 83 bpm and disappeared at 96bpm in the second patient.Both patients with this infrequent phenomenon are discussed and the literature is reviewed.展开更多
Aims: Left bundle branch block (LBBB) is generally associated with a poorer prognosis in comparison to normal intraventricular conduction, but also in comparison to right bundle branch block which is generally conside...Aims: Left bundle branch block (LBBB) is generally associated with a poorer prognosis in comparison to normal intraventricular conduction, but also in comparison to right bundle branch block which is generally considered to be benign in the absence of an underlying cardiac disorder like congenital heart disease. In this paper we evaluate the presence of possible cardiovascular pathology in a group of nurses with a low level of cardiovascular risk factors and left bundle branch block (LBBB). Methods: During the period 2009-2013, 356 nurses (mean age: 32.6 ± 11 yr) were admitted to the department of Occupational Medicine of Second University of Naples. Of these, 13 had LBBB. The evaluation of these patients has included an electrocardiogram (ECG), echocardiography, 24-h ambulatory Holter monitoring (ECG Holter), and exercise testing. Subsequently, in patients with LBBB, multislice computed coronary angiography (MSCT) has been considered. Results and Conclusion: Only in one patient we found a significant stenosis in the middle tract of left anterior descending artery. Coronary artery disease remains difficult to diagnose in some ECG findings such as acquired LBBB. For this reason, a preventive diagnose with newly developed diagnostic methods such as the multislice computed coronary angiography (MSCT) must try to account by the clinician in order to ruling out coronary artery disease (CAD) in workers with LBBB and low cardiovascular risk.展开更多
目的探讨宽胸气雾剂对冠状动脉多支病变患者血管内皮功能、炎症因子的影响。方法选取160例冠状动脉多支病变患者作为研究对象,用随机数字表法分为对照组和观察组,每组80例。2组均给予常规治疗,在此基础上,对照组给予尼可地尔片。观察组...目的探讨宽胸气雾剂对冠状动脉多支病变患者血管内皮功能、炎症因子的影响。方法选取160例冠状动脉多支病变患者作为研究对象,用随机数字表法分为对照组和观察组,每组80例。2组均给予常规治疗,在此基础上,对照组给予尼可地尔片。观察组在对照组治疗的基础上给予宽胸气雾剂。2组均持续治疗6个月。比较2组治疗后6个月的临床疗效及硝酸甘油停药率;比较2组治疗前和治疗后6个月西雅图心绞痛量表评分、中医证候积分、N-末端脑钠肽前体(N-terminal proBNP precursor,NT-proBNP)水平、心电图、炎症因子水平和血管内皮功能。结果治疗后6个月,观察组的总有效率(81.25%)、硝酸甘油停药率(23.75%)均高于对照组(66.25%、11.25%),P<0.05;2组疾病认知程度(degree of disease cognition,DS)、心绞痛稳定状态(stable state of angina pectoris,AS)、心绞痛发作情况(attack of angina pectoris,AF)、治疗满意度(treatment satisfaction,TS)、躯体活动受限程度(degree of physical activity restriction,PL)评分和血清一氧化氮(nitric oxide,NO)水平均升高,且观察组高于对照组(P<0.05);2组中医证候积分、NT-proBNP、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-10(interleukin-10,IL-10)、高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)和内皮素(endothelin,ET)水平均降低,且观察组低于对照组(P<0.05);2组室性早搏总次数、短阵室速发作次数、常规12导联心电图ST段的总和(∑ST)和常规12导联心电图ST段压低>0.25 mV导联数(routine 12 lead electrocardiogram ST segment depression>0.25 mV lead count,NST)均减少,且观察组少于对照组(P<0.05)。结论宽胸气雾剂能有效缓解冠状动脉多支病变患者的临床症状,减轻炎性反应,改善患者心功能和内皮功能,改善心电图指标,降低硝酸甘油的使用量,提高患者的生活质量。展开更多
文摘Exercise-induced left bundle branch block(EI-LBBB)is infrequent phenomenon.We present two patients with angina pectoris who developed EI-LBBB during exercise tolerance test.The first patient with typical angina pectoris had significant obstructive coronary artery disease(CAD)requiring percutaneous coronary intervention of multiple lesions including placement of drug eluting stents.The second patient had atypical chest pain without signs of CAD at all.EI-LBBB occurred at a heart rate of 80 bpm and 141 bpm in the first and second patient,respectively.EI-LBBB remained visible through the test till the recovery period in the first patient at a heart rate of 83 bpm and disappeared at 96bpm in the second patient.Both patients with this infrequent phenomenon are discussed and the literature is reviewed.
文摘Aims: Left bundle branch block (LBBB) is generally associated with a poorer prognosis in comparison to normal intraventricular conduction, but also in comparison to right bundle branch block which is generally considered to be benign in the absence of an underlying cardiac disorder like congenital heart disease. In this paper we evaluate the presence of possible cardiovascular pathology in a group of nurses with a low level of cardiovascular risk factors and left bundle branch block (LBBB). Methods: During the period 2009-2013, 356 nurses (mean age: 32.6 ± 11 yr) were admitted to the department of Occupational Medicine of Second University of Naples. Of these, 13 had LBBB. The evaluation of these patients has included an electrocardiogram (ECG), echocardiography, 24-h ambulatory Holter monitoring (ECG Holter), and exercise testing. Subsequently, in patients with LBBB, multislice computed coronary angiography (MSCT) has been considered. Results and Conclusion: Only in one patient we found a significant stenosis in the middle tract of left anterior descending artery. Coronary artery disease remains difficult to diagnose in some ECG findings such as acquired LBBB. For this reason, a preventive diagnose with newly developed diagnostic methods such as the multislice computed coronary angiography (MSCT) must try to account by the clinician in order to ruling out coronary artery disease (CAD) in workers with LBBB and low cardiovascular risk.
文摘目的探讨宽胸气雾剂对冠状动脉多支病变患者血管内皮功能、炎症因子的影响。方法选取160例冠状动脉多支病变患者作为研究对象,用随机数字表法分为对照组和观察组,每组80例。2组均给予常规治疗,在此基础上,对照组给予尼可地尔片。观察组在对照组治疗的基础上给予宽胸气雾剂。2组均持续治疗6个月。比较2组治疗后6个月的临床疗效及硝酸甘油停药率;比较2组治疗前和治疗后6个月西雅图心绞痛量表评分、中医证候积分、N-末端脑钠肽前体(N-terminal proBNP precursor,NT-proBNP)水平、心电图、炎症因子水平和血管内皮功能。结果治疗后6个月,观察组的总有效率(81.25%)、硝酸甘油停药率(23.75%)均高于对照组(66.25%、11.25%),P<0.05;2组疾病认知程度(degree of disease cognition,DS)、心绞痛稳定状态(stable state of angina pectoris,AS)、心绞痛发作情况(attack of angina pectoris,AF)、治疗满意度(treatment satisfaction,TS)、躯体活动受限程度(degree of physical activity restriction,PL)评分和血清一氧化氮(nitric oxide,NO)水平均升高,且观察组高于对照组(P<0.05);2组中医证候积分、NT-proBNP、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-10(interleukin-10,IL-10)、高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)和内皮素(endothelin,ET)水平均降低,且观察组低于对照组(P<0.05);2组室性早搏总次数、短阵室速发作次数、常规12导联心电图ST段的总和(∑ST)和常规12导联心电图ST段压低>0.25 mV导联数(routine 12 lead electrocardiogram ST segment depression>0.25 mV lead count,NST)均减少,且观察组少于对照组(P<0.05)。结论宽胸气雾剂能有效缓解冠状动脉多支病变患者的临床症状,减轻炎性反应,改善患者心功能和内皮功能,改善心电图指标,降低硝酸甘油的使用量,提高患者的生活质量。
