无器质性心脏病的室性早搏对运动试验反应的意义

探讨运动试验中室性早搏 (简称室早 )对运动的反应能否预测 2 4h动态心电图监测 (Holter)中自发性室早与心率的关系。无器质性心脏病的频发室早患者 73例 ,其中男 2 0例、女 5 3例 ,年龄 4 5± 12 (18～ 71)岁。根据运动试验达终点时室早的数量与运动前相比较 ,将患者分为室早增加组 17例以及室早减少或不变组 (简称室早减少组 )5 6 ,对二组患者的运动试验资料和Holter监测资料进行对比分析。结果 :两组运动试验检查的运动时间、最大运动级数、最大心率等无明显差异。经Holter监测在室早增加组 ,所有患者以小时为单位计算心率与室早数量的相关性 ,均显示心率与室早的数量呈正相关 ,而在室早减少组 ,则 4 7例 (83% )心率与室早的数量正相关 ,余 9例呈负相关。结论 :对无器质性心脏病的室早患者 ,在运动试验中室早数量增加与Holter检查的心率与室早数量的相关性具有一致性。而在运动试验中室早减少或不变的患者与Holter检查结果并不一致。

Value of Exercise Test for Premature Ventricular Contractions in Patients Without Organic Heart Disease

The aim of this study is to evaluate whether analysis of premature ventricular contractions (PVCs) during exercise test is capable of predicting their heart ra te dependency by means of 24h electrocardiographic monitoring (Holter). 73 patients with frequent (≥300/h) PVCs underwent treadmill exercise test and 24h Holter monitor ing in order to analyze the relationship between the number of PVCs and heart rate o f each individual hour. On the basis of the frequency of PVCs at maximal effort in comp arison with baseline found at exercise test, 2 groups of patients were identified: 17 p atients with increased PVCs (group A) and 56 with decreased or ucnchanged PVCs (group B) . The demographic characteristics and clinical findings were comparable between the tw o groups. In group A, correlation analysis of the number of PVCs and heart rate re vealed their positive correlation. In group B, they were positively correlated in only 47 patients (83%) but in the rest 9 patients they were negatively correlated. Conclusions: I n patients with PVCs but without organic heart disease, the increase of the number of PVCs during exercise test is consistent with the correlation index of the number of spontaneous PVCs and heart rate by 24h Holter monitoring, while there is no sign ificant relationship between the decrease of PVCs during exercise test and the 24h Holte r results.