運動によるSTセグメントの上昇:貧弱な心室機能と悪い予後を示すマーカー. 冠動脈外科研究 (CASS) シアトルハートウォッチの結果の確認

R A Bruce¹, L D Fisher, M Pettinger

¹Department of Medicine, University of Washington/the CASS Coordinating Center, Seattle.

Circulation

|April 1, 1988

まとめ

冠動脈性心疾患の患者の運動誘発性ST上昇は,特に運動と回復段階と組み合わせると,生存率が低いことを予測します. この発見は,侵襲的な心臓研究の前に貴重なものです.

科学分野:

心臓病学心臓病学
臨床運動生理学臨床運動生理学

背景:

冠動脈性心疾患 (CHD) の患者における運動誘発性ST上昇 (EISE) は,予後的有意性を示しています.
シアトル・ハート・ウォッチ (SHW) のような以前の研究では,コンピュータ平均を用いてEISEを分析した.

研究の目的:

CHD患者のより大きなコホートにおけるEISEの機能的および予後的重要性を評価する.
冠動脈外科手術研究 (CASS) とSHWコホート間のEISEの発見を比較する.

主な方法:

CASSのレジストリから3050人の患者を分析し,最初の発見,生存,および2次冠動脈イベントを6年以上にわたって調べました.
CASS患者のEISEは,SHWのコンピュータ平均法とは異なる視覚的解釈 (≥1mmのST上昇) によって特定されました.
CASSとSHWコホート間のEISEの流行と予後値の比較.

主要な成果:

EISEの罹患率は,CASSコホート (視覚解釈) で,SHWコホート (コンピュータ平均) と比較して低かった.
EISEのCASS患者は,以前の心筋梗塞と左心室機能不全の頻度が高いことを示しました.
低生存率は,CASSとSHWの両方で,運動と回復の間にEISEを持つサブグループで類似していました.

結論:

運動によるST上昇は,冠動脈性心疾患患者の生存率の低下の有意な予測因子である.
侵襲的な変数が知られている場合の独立した予測指標ではないが,EISEは,侵襲的な心臓評価の前に運動テストが行われる際の有用な予後マーカーである.

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