运动带来的ST段升高:是心室功能不佳和预后不佳的标志物. 冠状动脉外科研究 (CASS) 证实了西雅图心脏观察结果
R A Bruce1, L D Fisher, M Pettinger
1Department of Medicine, University of Washington/the CASS Coordinating Center, Seattle.
Circulation
|April 1, 1988
概括
在冠状动脉心脏病患者中,运动诱导的ST升高预示着生存率较低,特别是当与运动和恢复阶段相结合时. 这一发现在侵袭性心脏研究之前是有价值的.
科学领域:
- 心脏病学 心脏病学
- 临床运动生理学 临床运动生理学
背景情况:
- 在冠心病 (CHD) 患者中,运动诱导的ST升高 (EISE) 已经证明了预后意义.
- 以前的研究,比如西雅图心脏观察 (SHW),使用计算机平均计算分析了EISE.
研究的目的:
- 评估EISE在一个更大的心脏病患者队列中的功能和预后意义.
- 为了比较冠状动脉外科研究 (CASS) 和SHW队列之间的EISE发现.
主要方法:
- 从CASS注册表中分析了3050名患者,检查了6年来的初步发现,存活率和二次冠状动脉事件.
- 在CASS患者中,EISE通过视觉解释 (≥1毫米ST升高) 识别,与SHW的计算机平均方法不同.
- 在CASS和SHW队列之间比较EISE流行率和预后值.
主要成果:
- 在CASS队列 (视觉解释) 中,EISE的患病率低于SHW队列 (计算机平均化).
- 患有EISE的CASS患者表现出更高的先前心肌梗塞和左心室功能障碍的频率.
- 在CASS和SHW中,在运动和恢复期间患有EISE的子组中,糟糕的生存率相似.
结论:
- 运动诱导的ST升高是冠状动脉心脏病患者生存率低下的重要预测因素.
- 当侵入性变量已知时,虽然不是一个独立的预测指标,但当运动测试在侵入性心脏评估之前时,EISE是一个有用的预后标记.
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