80070001

open access

Version of Record

イッシ ビョウヘン シンキン コウソクショウ ニオケル ウンドウ フカチュウ ケッコウ ドウタイ ノ スイイ

Assessment of Hemodynamic Abnormalities during the Course of Exercise in Patients with Myocardial Infarction due to Single Vessel Disease

Japanese (日本語)

神戸大学医療技術短期大学部紀要

1

1-9

神戸大学医療技術短期大学部

1985

2007-11-21

The present study was performed to evaluate hemodynamic abnormalities during physical exercise in patients with ischemic heart disease due to single involved vessel. Thirty-three patients documented angiographically a significant stenosis of left anterior descending coronary artery underwent hemodynamic observation during exercise and TI-201 stress myocardial scintigraphy (SMS). Based on clinical findings and SMS, these patients were divided into large myocardial infarction (L-OMI, 11 cases), small myocardial infarction (S-OMI, 8 cases) S-OMI accompanying anginal pain (S-OMI + AP, 7 cases) and angina pectoris (AP, 7 cases) group. In both S-OMI and AP group, PAWP and CI during exercise increased concurrently, but the mag-nitude of increase in PAWP was smaller (P<0.005) and that in CI and CI/PAWP ratio were greater (P<0.05 and P<0.005 respectively) than AP group. Although the increase in PAWP was especially marked at maximun exercise in L-OMI group, there was no significant difference between PAWP in L-OMI and AP group. However, the magnitude of increase in PAWP in L OMI group was significantly greater (P<0.05) at the early stage of increased heart rate by 50% after starting exercise compared with that in AP group. Seven patients who developed anginal pain during exercise in S-OMI group had a greater increase in PAWP prior to the onset of angina, which had been al¬ready observed in AP group. Patients with severe coronary artery disease (stenosis 99 to 100%) and anginal pain had higher value of early/peak ΔPAWP during exercise, but there was no significant relationship between coronary collateral and hemodynamic re¬sponse to exercise in any group. In conclusion, in L OMI group, hemodynamic abnor¬malities at the early stage after starting exercise were suggestive of exercise-induced systolic left ventricular dysfunction. In S-OMI + AP group, hemodynamic response to exercise was similiar to that in AP group. In patients (S-OMI + AP and AP group) who developed anginal pain during exercise, hemodynamic response was different according to the severity of coronary artery disease.

紀要論文