T波のアルターナーネガティブの冠動脈疾患の患者は,エジェクションが低く,デフィブリレーターインプランテーションの恩恵を受けています
S H Hohnloser1, T Ikeda, D M Bloomfield
1Johann Wolfgang Goethe University, Frankfurt, Germany.
Lancet (London, England)
|July 18, 2003
まとめ
マイクロボルトT波の代替試験は,突然の心臓死のリスクが低い患者を特定することができます. T波の代替剤の検査が陰性である患者は,予防的な除細動器の埋め込みから利益を得ない可能性があります.
科学分野:
- 心臓病学 心臓病学
- 電気生理学 電気生理学
- 予防医学は,予防的な医療です.
背景:
- 予防的な除細動器のインプラントは,以前の心筋梗塞と低射出分数 (≤0.30) を有する患者に死亡率の利益を提供します.
- デフィブリレーターから恩恵を受けない患者を特定することは,治療とリソースの割り当てを最適化するために不可欠です.
研究 の 目的:
- マイクロボルトT波代替 (MTWA) テストの有用性を評価し,心室タキアリズムイベントのリスクが低い患者を特定する.
- MTWAテストが,予防的な除細動器の埋め込みを必要としないかもしれない患者を選択するのに役立つかどうかを判断するために.
主な方法:
- 前回の心筋梗塞と左心室噴出分数 ≤0.30の2つの臨床試験から129人の患者を遡及的に分析した.
- マイクロボルトのT波変数試験の将来的な評価.
- 急性心臓死および心臓発作停止の割合を評価するために24ヶ月間追跡調査を行った.
主要な成果:
- 24ヶ月でT波代替薬の陰性結果を持つ患者では,突然の心臓死または心臓発作が起こらなかった.
- 陽性なT波のアルターナンスの結果を持つ患者では,突然の心臓死または心臓発作の発生率15.6%が観察されました.
- MTWAテストは,この高リスク集団における心房タキアリズムイベントの高い負の予測値を示した.
結論:
- マイクロボルトT波のアルターナンスのテストは,以前の心筋梗塞とエジェクション分子が低下した患者のリスク分層化のための貴重なツールです.
- ネガティブなMTWAの結果は,心室タキアリズムイベントを経験する可能性が低い患者を特定し,予防的除細動器療法から利益を得られない可能性があることを示唆します.
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