在心脏应力测试中转诊的患者中,典型心肌痛的减少
Alan Rozanski1, Donghee Han2, Robert J H Miller3
1Division of Cardiology and Department of Medicine, Mount Sinai Morningside Hospital, Mount Sinai Heart, and the Icahn School of Medicine at Mount Sinai, 1111 Amsterdam Avenue, New York, NY, 10025, USA. alan.rozanski@mountsinai.org.
典型的胸痛患病率显著下降,呼吸障碍变得越来越常见. 尽管如此,典型的胸痛仍然表明诱导性心肌缺血的风险更高.
科学领域:
- 心脏病学 心脏病学
- 诊断成像 诊断成像 诊断成像
- 公共卫生 公共卫生
背景情况:
- 典型的胸痛是冠状动脉疾病的经典症状,其患病率发生了变化.
- 了解心痛表现的时间趋势对于准确的诊断和风险分层至关重要.
研究的目的:
- 分析典型性 angina 的流行长期趋势.
- 检查心肌痛症状,诱导性心肌缺血和冠状动脉疾病之间的关系.
主要方法:
- 从1991年至2017年,追溯分析了61,717名接受压力/休息SPECT心肌输液成像 (MPI) 的患者.
- 来自6,579名患者 (2011-2017年) 的冠状动脉CT血管学 (CCTA) 数据被用于评估血管学发现.
主要成果:
- 典型性心痛的患病率从16.2% (1991-1997) 降至3.1% (2011-2017).这种情况的发生率有所下降.
- 在同一时期,呼吸障碍的患病率从5.9%增加到14.5%.
- 典型的胸痛患者表现出更高的诱导性缺血率 (28.4%) 和阻塞性冠状动脉疾病,尽管三分之一的冠状动脉血管图正常.
结论:
- 典型的胸痛现在很少发生在接受心脏检测的患者中.
- 虽然典型的胸痛患者的血管检查结果各不相同,但该症状仍然是诱导性心肌缺血症的强有力的指标.
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相关概念视频
Angina III: Clinical Manifestations and Assessment
Exercise Stress Test
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
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