在压力测试期间异常压力心电图谱与正常心脏成像的意义 - - 一个元分析
Munthir Mansour1, Omar Alqaisi1, Nitesh Gautam1
1Department of Medicine, Division of Cardiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
不一致的压力测试,带有阳性心电图 (ECG),但阴性成像,表明发生重大心血管不良事件的风险更高. 基于成像模式的仔细解释对于患者的结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 诊断成像 诊断成像 诊断成像
- 临床决策 - 临床决策
背景情况:
- 冠状动脉疾病的诊断通常使用功能性压力测试与心电图和成像.
- 不一致的结果 (阳性心电图,阴性成像) 构成解释挑战和不确定的预后价值.
- 之前对不一致结果的研究已经 yielded混合的发现.
研究的目的:
- 进行已发表研究的元分析.
- 为了确定不一致的压力测试结果的意义 (阳性心电图,阴性成像).
主要方法:
- 搜索了PubMed,Cochrane和谷歌学者相关的研究.
- 包括报告功能性成像 (心声学或SPECT) 和心电图分析与主要不良心血管事件 (MACE) 随访的研究.
- 分析了9项涉及23715名患者的研究,使用随机效应模型.
主要成果:
- 不一致的结果与主要终点 (全因死亡或心肌梗塞) 的更高发病率有关.
- 主要终点的风险比为1.33与运动压力心声学.
- 药理学SPECT的初级终点风险比为6.53.
结论:
- 与正常测试相比,患有不一致的压力测试的患者面临心血管不良事件的风险增加.
- 预后影响因压力成像方式而异.
- 临床背景和仔细的解释对于不一致的结果至关重要.
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