虚血性心疾患患者の運動負荷所見に関する研究　　内科および外科的治療の前後における比較

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タイトル別名
  • CARDIORESPIRATORY RESPONSES TO EXERCISE TESTING IN PATIENTS WITH CORONARY ARTERY DISEASE
  • 内科および外科的治療の前後における比較

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Cardiorespiratory responses to treadmill exercise testing in 69 patients (average age 53 years) with coronary artery disease were studied before treatment and average of 23.9 months after the first study. Coronary angiography was performed in all of them before treatment, and 68 of 69 patients were found to have 75% or greater stenosis of one or more major coronary arteries. Thirty five patients (Medical group) were treated medically and 34 patients (Surgical group) were treated surgically (A-C bypass operation), including 24 and 15 patients with myocardial infarction respectively. The relationships between cardiorespiratory changes on exercise on one hand and clinical status and angiographical finding on the other were studied and compared between two groups.<br>In the first testing, there were no significant differences in mean values of oxygen consumption, Mets, oxygen pulse, heart rate, systolic blood pressure and rate-pressure-product between medical and surgical group. At the second testing using the same work load as the first testing, incidence of ST segment depression and angina was reduced from 24% in the first testing to 12% in medical group and from 46% to 4% in surgical group. Mean values of oxygen consumption, Mets and rate-pressure-product were also significantly decreased in both groups. Comparing the data of the two groups, there was significantly higher heart rate in surgical group than in medical group. At the time of the second testing, many of them already returned to their works.<br>At the even higher work load in the second testing, 7 medically treated patients with severe coronary artery disease were unable to complete the test because of ST segment depression and angina, on the other hand 33 surgically treated patients except one performed the test without angina even though some of them had had severe coronary artery disease before operation.<br>These results suggested that both medical and surgical treatment improved clinical findings and exercise performance, but surgical treatment was able to improve exercise performance more remarkably than medical treatment.

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