| OBJECTIVEBy use of heart remote monitoring techniques to monitor the incidence of silent myocardial ischemia in resting myocardial ischemia, distinguish the two mechanisms of resting myocardial ischemia and to analyze the incidence of every mechanism and the incidence of resting myocardial ischemia in different AS populations.METHODSCarry out the texts using heart remote monitoring techiques. Part one, select the patients who are monitored by the heart remote monitoring techiques from 2010.8 to 2010.12 and diagnosed with resting myocardial ischemia as the subjects. When there is something wrong with the patients'ECGs, the doctor in the heart remote monitoring center will make a telephone call to the patients and ask if the patients have symptoms. And ask the patients to write down a complete log. Then calculate the incidence of the silent myocardial ischemia in the resting myocardial ischemia. Part two, select the patients who have done both the coronary arteriography or CTA and Holter or iHolter in the heart remote monitoring center(2009.1.1--2010.12.31) as the subjects. Consult the patients' cases and reports of the Holter and iHolter. Analyze the incidence of the resting myocardial ischemia in different AS populations and the incidence of every mechanism of the resting myocardial ischemia.RESULTSPart one 57 people were collected in the text, in which 10 patients (18 %)had symptoms of myocardial isehemia,45 patients (79%) had silent myocardial ischemia(P<0.05), In patients who had silent myocardial ischemia,34 patients were males (89%) (P<0.05) and 11 females (58%) (P＜0.05). Patients senior to 60 years old were 30 (94%) (P＜0.05), junior to 60 years old 15 (60%) (P＜0.05).There were 192 attacks in the test, in which 31(16%) had symptoms and 161 (84%)had silent myocardial ischemia(P<0.05). The incidence of silent myocardial ischemia is larger in males and elders than in females and youngers(P<0.05). The majority of the attacks happened in 7:00AM.Part two The incidence of resting myocardial ischemia is more than 21.3% in patients whose coronary arteriography results are positive or the CTA reports show that the coronary artery has moderate or severe stenosis, while in patients whose coronary arteriography results are negative or the CTA reports show that the coronary artery has mild stenosis, the incidence is more than 58.3% (P<0.05). Coronary artery spasm account for more than 73.3% of all the etiologies of the resting myocardial ischemia, while the other etiology only accounts for less than 26.7%(P＜0.05).CONCLUSION1. Pains can not be regarded as the only standard of diagnosing the resting myocardial ischemia,especially in males and the old men.2. The heart remote monitoring techniques are favorable to monitor resting myocardial ischemia and silent myocardial ischemia.3. The coronary arteriography can be used to distinguish the two mechanisms of the resting myocardial ischemia.4. The coronary artery spasm makes the majority of the mechanisms of resting myocardial ischemia.5. The resting myocardial ischemia can more easily happen in patients without coronary artery disease, but whose coronary artery is narrow to some extent. |
