[Clinical characteristics of ischemic heart disease in the aged: significance of coronary revascularization and role of PTCA].
We investigated exercise capabilities of the elderly patients with significant coronary artery lesions and angina pectoris. The heart rate increased according to workload, but there were few cases in which maximal heart rate was obtained. There was a marked increase in VO2 at endpoint before sufficient work load was achieved. It suggested an increase in O2 demand of the myocardium and entire body. Left ventricular dysfunction from skeletal muscle fatigue and work load-induced myocardial anoxia were also suggested. The conditions of coronary arteries of aged patients and the method of treatment were studied on the basis of coronary angioplastic findings and exercise tolerance. We reviewed percutaneous transluminal coronary angioplasty (PTCA) performed in 49 aged patients (older than 70 years) with angina and investigated long-term results. In this group including 18 patients (43%) with multivessel disease, there was a high success rate (90%), and significant improvements in workload responses were achieved in early stages after PTCA. The rate of recurrence was higher in this group than non aged patients, however, angioplasty was repeated successfully in all of the patients. Dilated sites were recognized as patent in a majority of patients. Late cardiac events occurring six months after PTCA were acute myocardial infarction in only one case (2.2%) and unstable angina in three cases (6.8%). There was no cardiac death. The five-year cumulative survival rate was high (97%). During a follow-up interval of averaged 32 months, chest pain disappeared in 70% of patients and 48% enjoyed daily life without restriction. Since the quality of life appears to be improved and long term results are sufficiently acceptable, we concluded that PTCA is highly recommended for the elderly patients.
Yabe
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Cardiovaocular Diagnostic Laboratory Center, Toho University School of Medicine, Tokyo.
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D015444:Exercise / Q000502:physiology*; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D015996:Survival Rate