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Kokyu to Junkan Volume 31, Issue 10 （October 1983）

呼吸と循環 31巻10号（1983年10月発行）

Japanese English

研究

トレッドミル運動負荷試験における収縮期血圧上昇反応の乏しい症例の検討 The poor systolic blood pressurc response in submaximal treadmill exercise test 長谷川浩一 ¹ , 鼠尾祥三 ¹ , 三竹啓敏 ¹ , 原田頼続 ¹ , 寒川昌信 ¹ , 水谷敬一 ¹ , 布施野日出生 ¹ , 沢山俊民 ¹ Koichi Hasegawa ¹ , Shozo Nezuo ¹ , Hirotoshi Mitake ¹ , Yoritsugu Harada ¹ , Masanobu Samukawa ¹ , Keiichi Mizutani ¹ , Hideo Fuseno ¹ , Toshitami Sawayama ¹ ¹川崎医科大学内科循環器部門 ¹Division of Cardiology, Department of Medicine, Kawasaki Medical School pp.1131-1136

発行日 1983年10月15日 Published Date 1983/10/15

DOI https://doi.org/10.11477/mf.1404204322

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Abstract 文献概要
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　トレッドミル運動負荷試験（T試験と略）は，冠動脈疾患（CAD）の診断，重症度判定，リハビリテーションをはじめ各種心疾患の運動予備能の把握などの目的で広く用いられている。

　ThomsonとKelemenは，CADにおけるT試験中の収縮期血圧低下が，虚血性ST低下と同様にその重症度判定の指標になりうると報告している^1）。その後，同様の成績がMorris^2），Weiner^3）らによって報告されているが，彼らの方法によるとspecificityはきわめて高い反面，sensitivityが低く，日常臨床上の指標としては利用価値が低いと思われた。

The significance of the poor systolic blood pressure (SBP) response (Δ SBP≦25mmHg) during submaximal treadmill exercise test was investigated in 532 patients (430 males and 102 females) with definite or suspected coronary artery disease (CAD), arrhythmia and other cardiovascular abnormalities.

Eighty patients (64 males and 16 females) fulfilled criteria of the poor SBP response. Forty-three patients (53.8%) had CAD, 7 (8.8%) had cardiomyopathy, 3 (3.8%) had mitral valve prolapes (MVP) and 27 (33.3%) had no organic heart diseases.

In 19 CAD patients, treadmill exercise test was interrupted by angina pain and/or ST depression ≧2mm, and only 8 patients completed the exercis test. The poor SBP response was observed in 27 severe CAD such as angina pectoris (AP) with multi-vessel disease and anterior myocardial infarction (MI), while in quite a few (2) vasospastic angina and non-cardiac chest pain.

Ten of 34 young female patients without organic heart diseases who had the poor SBP response.

In conclusion, when subjects with cardiomyo-pathy, MVP and young women are excluded, the poor SBP response induced by treadmill exercise test may be one of the reliable indicators in identifying CAD with severely compromised left ventricular pump function such as AP with multi-vessel disease and MI.