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Kokyu to Junkan Volume 35, Issue 1 （January 1987）

呼吸と循環 35巻1号（1987年1月発行）

Japanese English

研究

狭心症におけるtreadmill運動負荷時の心電図P波の診断的意義 Diagnostic significance of P wave changs during treadmill exercise test in Angina pectoris 鼠尾祥三 ¹ , 長谷川浩一 ¹ , 原田頼続 ¹ , 寒川昌信 ¹ , 中尾正俊 ¹ , 米田元穂 ¹ , 忠岡信一郎 ¹ , 覚前哲 ¹ , 沢山俊民 ¹ Shōsō Nezuo ¹ , Kouichi Hasegawa ¹ , Yoritsugu Harada ¹ , Masanobu Samukawa ¹ , Masatoshi Nakao ¹ , Motoo Yoneda ¹ , Shinichiro Tadaoka ¹ , Satoshi Kakumae 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.89-95

発行日 1987年1月15日 Published Date 1987/1/15

DOI https://doi.org/10.11477/mf.1404204995

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Abstract 文献概要
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　Treadmill運動負荷試験は狭心症診断の有力な負荷試験として広く使用されている。しかし，運動負荷試験時におけるST下降は狭心症以外でも生じることがあり，その判定に迷うことも多い。一方，心電図V₁のP—terminal force （P-TF）は左室拡張末期圧や肺動脈楔入圧と高い相関を示すとされている^1〜8）。

　著者らもtrcadmill運動負荷時および負荷終了後におけるP-TFの変動について，狭心症例と健常例とでかなり異なった反応を示すことを報告した^9）。

In order to assess the clinical usefulness of P-terminal force (P-TF) response in V₁ during and after treadmill submaximal exercise test, 38 patients with exertional angina and 20 normal subjects were studied.

At rest, P-TF showed no significant differences be-tween patients and normal subjects.

At end point of treadmill test, P-TF was significantly greater in patients when compared to normal subjects (p<0. 05). Moreover, P-TF recovery time to control value after exercise was significantly delayed in patients than in normal subjects (p<0.01).

The sensitivity of abnormal P-TF response (3.0 msec mV or greater) for angina pectoris was 71%, the specificity 87. 4% and the predictive value S7%.

The sensitivity of abnormal P-TF recovery time (6.0 min or more) for angina pectoris was 84%, the speci-ficity 76% and predictive value 89%.

The sensitivity of either abnormal P-TF response (3.0msec mV or greater) or abnormal P-TF recovery time (6.0 min or more) for angina pectoris was 89%, the specificity 65% and the predictive value 83%.

Similar results were observed in selected subjects (including patients and normal subjects) with ST de-pression of 0.1mV or more at end point.

At end point, systolic blood pressure (SBP) response was good and P-TF was small in normal subjects. In one vessel disease patients, SBP response was good when P-TF was great at end point. On the contrary, in three vessel disease patients SBP response was poor and P-TF was great.

It is our conclusion that the abnormal P-TF at end point, abnormal relation of SBP response and P-TF at end point and abnormal P-TF recovery time after exercise were clinically useful in identifying patient with angina pectoris.