雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Kokyu to Junkan Volume 33, Issue 8 （August 1985）

呼吸と循環 33巻8号（1985年8月発行）

Japanese English

研究

前壁梗塞における運動負荷時下壁誘導（III,aV_F）でのST低下の臨床的意義 Clinical significance of exercise-induced ST-segment depression in inferior leads in patients with anterior myocardial infarction 佐藤邦友 ¹ , 扇谷信久 ¹ , 加納繁美 ¹ , 福井須賀男 ² , 南野隆三 ² , 金奉賀 ³ Kunitomo Satoh ¹ , Nobuhisa Ohgitani ¹ , Shigemi Kanoh ¹ , Sugao Hukui ² , Takazo Minamino ² , Hoga Kim ³ ¹北大阪病院循環器内科 ²桜橋渡辺病院循環器内科 ³大阪大学病院第一内科 ¹Division of Cardiology, North Osaka Hospital ²Division of Cardiology, Sakurabashi Watanabe Hospital ³The First Department of Internal Medicine, Osaka University Medical School pp.1017-1023

発行日 1985年8月15日 Published Date 1985/8/15

DOI https://doi.org/10.11477/mf.1404204727

PDF(7244KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

　急性心筋梗塞例の退院前に運動負荷試験を行い，心電図変化と運動能を評価することは，退院後のリハビリテーション計画，治療方針の決定，予後の予測上重要である^1〜5）。従来より心筋梗塞例の運動負荷心電図より梗塞部誘導でのST偏位と冠血管病変及び梗塞部左室壁運動異常との関係について検討した報告^6〜9）は多い。しかし，非梗塞部誘導でのST偏位についてその成因を検討した報告は少い。そこで今回著者らは初回前壁梗塞例について運動負荷時の非梗塞部（下壁）誘導（III,aV_F）におけるST低下の機作について検討した。

In order to evaluate clinical significance of exer-cise-induced ST depression (ST ) in inferior leads (III, aVF) in patients with first anterior transmural myocardial infarction (ML, 108 patients with an-terior MI were performed symptom-limited multi-stage exercise test in supine position using a bicycle ergometer about two months after the onset of MI. 12-lead ECG was obtained before and during the exercise test. CAG and LVG were performed by Judkins' technique.

Results : 1) 18 of 108 patients (44.4%) had ST↓, in leads III and aVF during exercise test, 56 (51.9%) no ST change (ST→) and 4 (3.7%) ST elevation (ST↑). 2) While no significant rela-tion of exercise-induced ST change to age, sex, exercise tolerance and rate pressure product at the endpoint of exercise test, 14 of 17 patients who hadchest pain during exercise test had exercise-induced ST↓.3) 19 of 18 patients (39.6%) with exercise-induced ST↓ had multivessel disease. On the other hand, 29 patients (60.4%) had single vessel disease (SVD) or no significant coronary artery lesion (OVD). 4) While only one of 39 patients with SVD or OVD who had ST ; in leads V_1~6 had ST↓ in leads III and aVF, 20 of 21 patients (95.2%) with ST t in leads I or aVL had ST↓in leads III, aVF. 5) S of 20 patients who had ST→ in anterior leads had ST↓) in inferior leads. These patients had severe coronary artery narrow-ing in proximal portion of LAD.

These findings indicate that mechanism of ST↓in III, aVF were (1) coronary artery lesion of vessel related to inferior area, (2) reciprocal chan-ges of ST↑ in leads I, aVL and (3) ischemia around anterior infarct.