阴性T波替代体冠状动脉患者的射出率较低,并从除器植入中受益
S H Hohnloser1, T Ikeda, D M Bloomfield
1Johann Wolfgang Goethe University, Frankfurt, Germany.
Lancet (London, England)
|July 18, 2003
概括
微电压T波替代体测试可以确定心脏突然死亡风险较低的患者. 对T波替代体检测负的患者可能不会从预防性除器植入中受益.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 预防医学 预防医学
背景情况:
- 预防性除器植入为以前心肌梗塞和低射出分数 (≤0.30) 的患者提供了死亡益处.
- 识别那些不会受益于除器的患者对于优化治疗和资源配置至关重要.
研究的目的:
- 评估微伏特T波交替 (MTWA) 测试在识别患有心室动脉节律事件低风险的患者中的实用性.
- 为了确定MTWA测试是否可以帮助选择可能不需要预防性除器植入的患者.
主要方法:
- 从两项临床试验中对129名患者进行了回顾性分析,这些患者先前患有心肌梗塞,左心室喷射率≤0.30.
- 对微伏T波交替试验的前性评估.
- 24个月的随访,以评估心脏突然死亡和心脏骤停的发生率.
主要成果:
- 没有突然的心脏死亡或心脏骤停发生在患者与负的T波替代结果在24个月.
- 有阳性T波替代结果的患者中,突然心脏死亡或心脏骤停的发病率为15.6%.
- 在这种高风险人群中,MTWA测试显示了腹腔动脉节拍事件的高负预测值.
结论:
- 微电压T波交替测试是先前心肌梗塞和减少喷射分数的患者风险分层的一个有价值的工具.
- 负的MTWA结果确定患者不太可能经历腹腔动脉节拍事件,这表明他们可能不会从预防性除器治疗中受益.
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