"静かな"心筋不全症は,症状性心筋不全症と同じくらい重症なのでしょうか? 患者の選択バイアスの分析効果は,バイアスです
J Klein1, S Y Chao, D S Berman
1Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, Calif.
Circulation
|May 1, 1994
まとめ
運動ストレステスト中の胸痛は,幅広い患者グループにおいて,より多くの機能的異常を示している. しかし,この関連性は,誘導性イシュケミアの可能性が高い患者で弱まります.
科学分野:
- 心臓病学 心臓病学
- 診断用イメージング
- 運動生理学 運動生理学
背景:
- 運動による胸痛の臨床的意義は,相反する研究により議論されている.
- 患者の選択バイアスは,研究結果の解釈に影響を与える可能性があります.
研究 の 目的:
- サイレント対症状性イシュケミアの機能的意義を比較する.
- 運動による胸痛の分析における患者選択バイアスの影響を評価する.
主な方法:
- トレードミルのテスト中に不血性STセグメントうつ病を患った117人の患者を対象とした前向きな研究.
- Thallium-201の心筋 perfusion シングルフォトンエミッションコンピューティングトモグラフィー (SPECT) と24時間AMBULATORY ECGモニタリングを使用しました.
- ヘモダイナミック,運動,心電図のパラメータに基づいて,静かな対症状性イシュケミアのコホートを比較した.
主要な成果:
- 症状のある患者は,より短い運動期間,より低いピーク心拍数,およびより多くの外来STセグメントうつ病を示した.
- 胸痛の患者は,Tl-201 SPECTで,より高い頻度でイシュケミアを発症し,Tlのリバーシビリティが高くなりました.
- 集団の制限によってコホート間の差異は減少したが,絶対性缺血の重症度は増加した.
結論:
- 胸の痛みは,より広範な冠動脈疾患の集団におけるより機能的な異常と関連しています.
- 臨床パラメータとしての胸痛の価値は,誘導性イシュケミアの先入観的な可能性が高い集団で減少する.
- 発見は,医学文献の矛盾する報告を調和させるのに役立つかもしれない.
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