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目的探讨平板运动负荷试验时发生的室性心律失常与冠状动脉病变之间的关系。方法对166例平板运动试验中出现的室性心律失常患者行冠状动脉造影术,分析冠脉病变及程度。结果将平板运动试验结果分为偶发室早、频发室早、多源成对室早、短阵室速、室颤5组。将冠状动脉造影狭窄≥50%定为冠造阳性。冠脉造影阳性分为左主干、左前降支、回旋支、右冠4组。结果显示:166例冠脉造影中92例患者冠造阳性。66例偶发室早中30例冠造阳性;67例频发室早中38例冠造阳性;26例多源成对室早中17例冠造阳性;短阵室速6例和室颤1例冠造均为阳性。左主干、左前降支狭窄的程度越重的患者,短阵室速、室颤发生率明显增高(P<0.01)。结论运动试验诱发室性心律失常的数量越多、级别越高,累及血管病变的程度越重,提示危险性越高,对冠心病的诊断及危险分层有较大的临床意义。
Objective To investigate the relationship between ventricular arrhythmias and coronary artery lesions during treadmill exercise test. Methods A total of 166 patients with ventricular arrhythmias undergoing treadmill exercise test underwent coronary angiography to analyze the degree of coronary artery lesion. Results The treadmill exercise test results were divided into sporadic premature ventricular contractions, frequent premature ventricular contractions, multiple sources of early ventricular tachycardia, ventricular tachycardia, ventricular fibrillation in five groups. Coronary angiography stenosis ≥ 50% as the crown-made positive. Coronary angiography positive divided into left main, left anterior descending branch, circumflex artery, right coronary 4 groups. The results show that: 166 cases of coronary angiography in 92 patients with positive crown made. Among the 66 cases, 30 cases were found to be positive in the morning, 38 cases were early positive in 67 cases, and 17 cases were positive in 26 cases in early morning. The incidence of ventricular tachycardia in 6 cases and 1 case of ventricular fibrillation Crown made are positive. In the left main, patients with more severe left anterior descending aorta had a significantly higher incidence of ventricular tachycardia and ventricular fibrillation (P <0.01). Conclusion The higher the number of ventricular arrhythmias induced by exercise test, the higher the grade and the more severe vascular lesions, suggesting that the higher the risk is, the greater the clinical significance of diagnosis and risk stratification of coronary heart disease.