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Objective To observe the effect of Tongyang-Kuanxiong guanule combined with conventional western medicine for the stable angina pectoris (SAP) with qi and phlegm and blood stasis syndrome. Methods Eighty-six SAP patients who met the inclusion criteria were randomly divided into two groups according to the digital table method, with 43 cases in each group. The control group was treated with routine Western medical therapy. The observation group was given Tongyang-Kuanxiong guanule on the basis of the control group. Both groups were treated for 28 days. The TCM syndromes and angina pectoris scores were evaluated before and after treatment. The treadmill exercise test was used to observe the duration of exercise, the metabolic equivalent, the maximum value of ST segment depression, the heart rate at maximum load, the duration of ST segment depression. And the adverse reactions were recorded. Results The total effective rate was 88.4％ (38/43) in the observation group and 67.4％ (29/43) in the control group. The difference between the two groups was statistically significant (χ2=5.549, P=0.018). After treatment, the duration of exercise (9.5 ± 1.2 min vs. 8.6 ± 1.2 min, t=3.371), metabolic equivalent (10.8 ± 2.5 METs vs. 9.2 ± 2.4 METs, t=3.084) in the observation group were significantly higher than those in the control group (P<0.01 or P<0.05). The largest degree of ST segment changes (1.2 ± 0.6 mV vs. 1.9 ± 0.6 mV, t=5.484), and the duration of ST segment descent (125.0 ± 94.5 s vs. 162.4 ± 96.9 s, t=1.795) in the observation group were significantly lower than those in the control group (P<0.01 or P<0.05). Thefrequency of angina attacks (9.7 ± 1.6 times per week vs. 17.3 ± 2.1 times per week, t=18.778), duration of attacks (3.2 ± 1.4 min vs. 6.4 ± 1.5 min, t=10.146) consumption of nitroglycerin (1.3 ± 0.8 mg vs. 2.5 ± 0.8 mg, t=7.624) and Symptom score (8.3 ± 2.8 vs. 12.5 ± 3.1, t=6.593) in the observation group were significantly lower than the control group (P<0.01). Conclusions The Tongyang-Kuanxiong guanule can significantly improve the exercise tolerance of SAP patients with qi and phlegm and blood stasis, reduce myocardial oxygen consumption, improve angina pectoris and reduce the number of angina attacks.
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INTRODUCTION : Exercise-induced ventricular arrhythmia (EIVA) and autonomic imbalance are considered as early markers of heart disease in Chagas disease (ChD) patients. The objective of the present study was to verify the differences in the occurrence of EIVA and autonomic maneuver indexes between healthy individuals and ChD patients with no apparent cardiac involvement. METHODS : A total of 75 ChD patients with no apparent cardiac involvement, aged 44.7 (8.5) years, and 38 healthy individuals, aged 44.0 (9.2) years, were evaluated using echocardiography, symptom-limited treadmill exercise testing and autonomic function tests. RESULTS : The occurrence of EIVA was higher in the chagasic group (48%) than in the control group (23.7%) during both the effort and the recovery phases. Frequent ventricular contractions occurred only in the patient group. Additionally, the respiratory sinus arrhythmia index was significantly lower in the chagasic individuals compared with the control group. CONCLUSIONS : ChD patients with no apparent cardiac involvement had a higher frequency of EIVA as well as more vagal dysfunction by respiratory sinus arrhythmia. These results suggest that even when asymptomatic, ChD patients possess important arrhythmogenic substrates and subclinical disease. .
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Adult , Female , Humans , Male , Middle Aged , Chagas Disease/physiopathology , Exercise Test , Tachycardia, Ventricular/physiopathology , Case-Control Studies , Cross-Sectional Studies , Electrocardiography , Tachycardia, Ventricular/etiologyABSTRACT
Objective To explore the significance of treadmill exercise test (TET) in identifying left main coronary artery(LMD) obstruction from proximal left anterior descending(LAD) obstruction.Methods Patients with positive in the TET of the Central Hospital of Dalian from Jan.2008 to Dec.2013 were enrolled in this study and they were divided into LMD group with 21 cases and LAD group with 35 cases according to the results of coronary angiography.Retrospectively study was conducted to analyze the exercise time,the start time of ST segment change,the lead of ST segment between groups.Results Lead aVR ST segment elevation(≥0.10 mV) was 85.7％ (18/21) in the LMD group and 62.9％ (22/35) in the LAD group.Lead aVR ST segment elevation in the LM group was ((0.16 ± 0.07) mV,higher than in the LAD group ((0.11 ± 0.07) mV ; t =2.614,P ＜ 0.05).Accompany ST segment depression of leads and cumulative ST segment depression were (5.7 ±1.7) pcs and (1.13 ±0.42) mV in LMD group,significantly higher than those of LAD group((4.6 ± ± 1.8) pcs and (0.87 ± 0.32) mV ; t =2.314,2.634,P ＜ 0.05).The occurrence rate of ST segment depression (≥0.10 mV) in leads V2 and V6 were 33.3％ (7/21) and 90.5％ (19/21) in LM group,significantly higher than that in LAD group (11.4％ (4/35) and 62.9 ％ (22/35) ; x2 =3.990,5.105 ;P ＜ 0..05).The start time of ST segment deviation of LM group was significantly earlier than that of LAD group ((199.8 ± 70.8) s vs.(273.7 ± 127.3) s;t =-2.787,P ＜ 0.01).The differences were not statistically significant in terms of the exercise time between groups ((315.0 ± 120.0) s vs.(376.1 ± 110.0) s;t =-1.948;P ＞ 0.05),the rate for achieving target heart rate(33.3％ (7/21) vs.48.6％ (17/35) ; x2 =1.244 ; P ＞ 0.05) and the Duke score ((-11.8 ±7.2) vs.(-8.4 ±6.8) ;t =-1:772;P＞0.05).Conclusion Compare with patients with the LAD disease,ST segment elevation of lead aVR is significantly higher induced by treadmill exercise test in patients with left main disease.Meanwhile,the lead accompanied with ST segment depression is significantly higher,and the start time of ST segment deviation is significantly earlier.
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ObjectiveTo evaluate the value of 24 h dynamic electrocardiogram (DCG) and treadmill exercise testing(TET) in diagnosing coronary heart disease(CHD),and analyze relevant index between coronary arteriography(CAG) and treadmill exercise testing.MethodsOne hundred and forty-nine borderline cases of coronary heart disease were enrolled.Every patient was examined by DCG,TET,and CAG,compared the diagnostic value of TET combined with DCG and TET or DCG alone,and record the increased heart rate during the first minute( △ HRl min) of TET and systolic blood pressure(SBP) recovery.The patients were divided into a CHD group and a non-CHD group according to the results of coronary angiography.ResultsThe sensitivity rate was 78.57％ and specific rate was 70.77％ by means of TET.The sensitivity rate was 61.90％ and specific rate was 66.15％ by means of DCG.The sensitivity rate was 95.23％ ,specific rate was 55.38％,positive predictive value was 73.39％ and negative predictive value was 90.00％ by parallel way of DCG and TET,its sensitivity rate (95.23％) and negative predictive value (90.00％ ) were more than those of DCG or TET alone.The sensitivity rate was 52.38％,specific rate was 95.38％,positive predictive value was 93.62％ and negative predictive value was 60.78％ by serial way of DCG and TET,its specific rate (95.38％) and positive predictive value (93.62％ ) were more than those of DCG or TET alone.The number of men in the CHD group was higher than the number of women.Ratio of systolic blood pressure recovery(rSBPR) in the CHD group was significantly higher than that in the non-CHD group ( P ＜ 0.01 ).Conclusion It can obviously enhance the sensitivity rate and specific rate if combined TET with DCG.Patients with CHD have a delayed decline in SBP during recovery which can be one of the indexes to estimate the extent of myocardial ischemia and coronary artery lesion.
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@#ObjectiveTo investigate the safety and clinical value of treadmill exercise testing for the patients with acute myocardial infarction in the early recovery. Methods36 patients with acute myocardial infarction performed treadmill exercise testing with Bruce protocol 15～57 d after infarction. ResultsThe outcome of 19 cases was positive, and the outcome of other 16 cases was negative. 1 case couldn't finish the testing, whose outcome could not be analyzed because his exercise time was too short. The average cardic fuction was (5.42±3.12) METs. ConclusionIt is safe that the patients with acute myocardial infarction performed treadmill exercise testing early.