EFFECTS OF CARBON-MONOXIDE ON MYOCARDIAL-ISCHEMIA

被引:54
作者
ALLRED, EN
BLEECKER, ER
CHAITMAN, BR
DAHMS, TE
GOTTLIEB, SO
HACKNEY, JD
PAGANO, M
SELVESTER, RH
WALDEN, SM
WARREN, J
机构
[1] ST LOUIS UNIV,SCH MED,DEPT ANAESTHESIOL,3635 VISTA AVE,ST LOUIS,MO 63110
[2] HARVARD UNIV,SCH PUBL HLTH,DEPT BIOSTAT,BOSTON,MA 02115
[3] JOHNS HOPKINS UNIV,SCH MED,DEPT MED,BALTIMORE,MD 21205
[4] ST LOUIS UNIV,SCH MED,DEPT INTERNAL MED,ST LOUIS,MO 63104
[5] ST LOUIS UNIV,SCH MED,DEPT SURG,ST LOUIS,MO 63104
[6] RANCHO LOS AMIGOS MED CTR,ENVIRONM HLTH SERV,DOWNEY,CA
[7] RANCHO LOS AMIGOS MED CTR,CARDIOL SERV,DOWNEY,CA
[8] HLTH EFFECTS INST,CAMBRIDGE,MA
关键词
D O I
10.2307/3430988
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
The purpose of this study was to determine whether low doses of carbon monoxide (CO) exacerbate myocardial ischemia during a progressive exercise test. The effect of CO exposure was evaluated using the objective measure of time to development of electrocardiographic changes indicative of ischemia and the subjective measure of time to onset of angina. Sixty-three male subjects (41-75 years) with well-documented coronary artery disease, who had exertional angina pectoris and ischemic ST-segment changes in their electrocardiograms, were studied. Results from three randomized, double-blind test visits (room air, low and high CO) were compared. The effect of CO exposure was determined from the percent difference in the end points obtained on exercise tests performed before and after a 1-hr exposure to room air or CO. The exposures resulted in postexercise carboxyhemoglobin (COHb) levels of 0.6% +/- 0.3%, 2.0% +/- 0.1%, and 3.9% +/- 0.1%. The results obtained on the 2%-COHb day and 3.9%-COHb day were compared to those on the room air day. There were 5.1% (p = 0.01) and 12.1% (p less-than-or-equal-to 0.0001) decreases in the time to development of ischemic ST-segment changes after exposures producing 2.0 and 3.9% COHb, respectively, compared to the control day. In addition, there were 4.2% (p = 0.027) and 7.1% (p = 0.002) decreases in time to the onset of angina after exposures producing 2.0 and 3.9% COHb, respectively, compared to the control day. A significant dose-relationship was found for the individual differences in the time to ST end point and angina for the pre- versus postexposure exercise tests at the three carboxyhemoglobin levels. These findings demonstrate that low doses of CO produce significant effects on cardiac function during exercise in subjects with coronary artery disease.
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页码:89 / 132
页数:44
相关论文
共 58 条
[51]  
Wayne EJ, 1933, CLIN SCI, V1, P103
[52]   SIGNIFICANCE OF SILENT-MYOCARDIAL-ISCHEMIA DURING EXERCISE TESTING IN PATIENTS WITH CORONARY-ARTERY DISEASE [J].
WEINER, DA ;
RYAN, TJ ;
MCCABE, CH ;
LUK, S ;
CHAITMAN, BR ;
SHEFFIELD, LT ;
TRISTANI, F ;
FISHER, LD .
AMERICAN JOURNAL OF CARDIOLOGY, 1987, 59 (08) :725-729
[53]   EXERCISE STRESS-TESTING - CORRELATIONS AMONG HISTORY OF ANGINA, ST-SEGMENT RESPONSE AND PREVALENCE OF CORONARY-ARTERY DISEASE IN THE CORONARY-ARTERY SURGERY STUDY (CASS) [J].
WEINER, DA ;
RYAN, TJ ;
MCCABE, CH ;
KENNEDY, JW ;
SCHLOSS, M ;
TRISTANI, F ;
CHAITMAN, BR ;
FISHER, LD .
NEW ENGLAND JOURNAL OF MEDICINE, 1979, 301 (05) :230-235
[54]  
1980, OPERATORS MANUAL IL2
[55]  
[No title captured]
[56]  
1986, DHHS PHS861588 PUBL
[57]  
1984, EPA450584004 STRAT A
[58]  
1979, EPA600879022