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Kokyu to Junkan Volume 46, Issue 5 （May 1998）

呼吸と循環 46巻5号（1998年5月発行）

Japanese English

研究

トレッドミル，エルゴメーターのいずれがより有用か—器質的冠狭窄を認めない冠攣縮性狭心症の診断法として Which Method is More Useful, the Treadmill or the Ergometer Procedure as a Diagnostic Tool for Detecting Ischemic Evidence in Patients with Vasospastic Angina without Significant Stenosis ? 末田章三 ¹ , 三根生和明 ¹ , 近藤直志 ¹ , 矢野和夫 ¹ , 越智隆明 ¹ , 越智直登 ² , 福田浩 ² , 茎田仁志 ² , 川田浩之 ³ , 松田昌三 ³ , 浦岡忠夫 ³ Shozo Sueda ¹ , Kazuaki Mineoi ¹ , Tadashi Kondou ¹ , Kazuo Yano ¹ , Takaaki Ochi ¹ , Naoto Ochi ² , Hiroshi Fukuda ² , Hitoshi Kukita ² , Hiroyuki Kawada ³ , Shouzou Matsuda ³ , Tadao Uraoka ³ ¹鷹の子病院循環器科 ²宇和島社会保険病院循環器科 ³喜多医師会病院循環器科 ¹Department of Cardiology, Takanoko Hospital ²Department of Cardiology, Uwajima Social Insurance Hospital ³Department of Cardiology, Kita Medical Association Hospital キーワード：冠攣縮性狭心症 , トレッドミル , 自転車エルゴメーター , vasospastic angina , treadmill exercise , bicycle ergometer Keyword: 冠攣縮性狭心症 , トレッドミル , 自転車エルゴメーター , vasospastic angina , treadmill exercise , bicycle ergometer pp.499-503

発行日 1998年5月15日 Published Date 1998/5/15

DOI https://doi.org/10.11477/mf.1404901695

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Abstract 文献概要
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　50％以上の器質的冠動脈硬化を認めない冠攣縮性狭心症24例を対象に，過換気負荷後に急速運動負荷を施行する場合の虚血誘発負荷試験として，トレッドミル負荷（HV＋TM）または自転車エルゴメーター負荷（HV＋ER）のいずれがより臨床的に有用か否かについて検討した．胸部症状はHV＋TM群で54％，HV＋ER群で42％，心電図変化はHV＋TM群で54％，HV＋ER群で29％に認め，いずれもHV＋TM群で高値を呈したが有意差は認められなかった．胸部症状か心電図変化をHV＋TM群で71％，HV＋ER群で58％に認めた．HV＋ER負荷を用いた²⁰¹T1心筋シンチでは63％に再分布所見を認めた．冠攣縮性狭心症例の虚血誘発負荷試験として，過換気負荷後に追加する運動は自転車エルゴメーターに比し，トレッドミル負荷試験のほうがわれわれ日本人には適していると思われた．

We examined which procedure, the treadmill or the bicycle ergometer exercise test, was clinically more useful for detecting ischemic evidence in patients with vasospastic angina who had no fixed stenosis exceeding 50 percent. Both a modified treadmill exercise test staged up at every minute based on Bruce protocol after five minutes' hyperventilation (HV+TM) and a bicycle ergometer exercise test with increments of 25 watt every one minute after five minutes' hyperventilation (HV + ER) were performed in all 24 patients for induc-ing the appearance of chest symptoms and/or positive ECG changes. While chest symptoms were determined in 54% of patients during HV+TM and in 42% during HV+ ER, positive ECG changes were obtained in 54% during FIV +TM and in 29% during HV+ER. There was no statistical difference between the two procedures concerning the appearance of chest symptoms and posi-tive ECG changes. Chest symptoms and/or positive ECG changes were also determined in 71% with HV+TM and in 58% with HV+ER. However, there was no significant difference between the two tests. Rate pres-sure product revealed no statistical difference between the two procedures. Only 63% of patients disclosed ischemic redistribution by performing ²⁰¹T1 myocardial scintigraphy using HV +ER.

We concluded that treadmill exercise was superior to bicycle ergometer exercise for the induction of ischemic evidence in Japanese patients with vasospastic angina but who had no significant stenosis.