运动诱发无狭窄冠状动脉扩张症病人心肌缺血

目的 探讨运动是否会引起冠脉无明显狭窄的冠状动脉扩张症病人心肌缺血表现。方法 分析2002年1月至2004年1月间41例(男36例,女4例)经选择性冠状动脉造影证实的冠脉无明显狭窄但有冠状动脉扩张症病人,作为研究组;另选取同期41例按性别、年龄等配对的冠脉造影结果正常的作为对照组,冠脉造影前进行临床调查及活动平板检查。结果 研究组18例(43.9%)病人有典型心绞痛症状,而对照组仅2例有典型心绞痛症状,两组对比有显著差异(χ²=10.498,P=0.001);研究组32例(78%)活动平板阳性,与对照组5例(12.2%)阳性比差异有显著性(χ²=35.903,P<0.0001)。结论 冠状动脉扩张症病人,虽然冠脉无明显狭窄,但可有典型心绞痛症状,运动可以诱发心肌缺血表现,应当引起临床重视。

Exercise-induced myocardial ischemia in patients with coronary artery ectasia without significant coronary stenosis

Objective To investigate whether exercise would induce myocardial ischemia in patients with coronary artery ectasia without significant coronary stenosis. Methods A total of 41 patients (male 29,female 12) with coronary artery ectasia without significant coronary stenosis,confirmed by selective coronary angiography,were enrolled in the study group.Forty-one patients with normal coronary arteries were in the control group.All the patients received a clinical examination and treadmill exercise before selective coronary angiography. Results Eighteen patients (43.9%) had typical angina in the study group with respect to two patients in the control group (χ²=10.498,P=0.001).In the study group,32 cases had positive treadmill test with respect to five cases in the control group (χ²=35.903,P<0.0001). Conclusion Patients with coronary artery ectasia without significant coronary stenosis could get typical angina.Exercise could induce myocardial ischemia which should be paid attention to.