CLINICAL-SIGNIFICANCE OF SUPRAVENTRICULAR TACHYARRHYTHMIAS AFTER ACUTE MYOCARDIAL-INFARCTION
CLINICAL-SIGNIFICANCE OF SUPRAVENTRICULAR TACHYARRHYTHMIAS AFTER ACUTE MYOCARDIAL-INFARCTION
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DOI：
10.1093/oxfordjournals.eurheartj.a062135
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发表时间：
1986-09-01
影响因子：
39.3
通讯作者：
VECCHIO, C
中科院分区：
文献类型：
--
作者：
BERISSO, MZ;FERRONI, A;VECCHIO, C
对160例急性心肌梗死（AMI）幸存者进行评估，以评估急性事件后出院时发生的室上性心动过速（SVTA）的临床意义。研究中考虑的变量是在出院前估计的；采用24 h热心电图监测系统对心律失常进行量化。SVTA发生88例（55%）。单次或重复室上早搏65例（41%），阵发性房性心动过速20例（12%），心房扑动或颤动3例（2%）。双变量统计分析显示，性别、既往心血管病史、类型、AMI和SVTA发生部位无相关性。年龄、左房径（LAD）、心胸比（CTR）与SVTA发生密切相关；左室射血分数（LVEF）呈反比关系。SVTA的存在与年龄> 55岁、LAD > 40 mm、LVEF < 45%、血清肌酸激酶峰值水平> 1400 μ l - 1、CTR > 0.49显著相关。多因素统计分析显示，年龄、LAD、LVEF、左室缩短、CTR是区分SVTA患者的重要因素。AMI后出院时发生的SVTA是左心室泵功能受损的指示。
160 survivors of acute myocardial infarction (AMI) were evaluated to assess the clinical significance of supraventricular tachyarrhythmias (SVTA) occurring at discharge from the hospital after the acute event. the variables considered for the study were estimated before hospital discharge; arrhythmias were quantified with a 24 h Hotter ECG monitoring system. SVTA occurred in 88 patients (55%). Single or repetitive supraventricular premature beats were found in 65 (41%), paroxysmal atrial orjunctional tachycardias in 20 (12%), bouts of atrial flutter or fibrillation in 3 (2%). Bivariate statistical analysis showed no relationship between sex, previous cardiovascular history, type, and location of AMI and SVTA occurrence. A close positive relationship was found between age, left atrial dimension (LAD), cardio-thoracic ratio (CTR) and SVTA occurrence; an inverse relationship was found for left ventricular ejection fraction (LVEF). The presence of SVTA appeared significantly related to age above 55 years, to LAD greater than 40 mm, to LVEF less than 45%, to serum creatine kinase peak levels over 1400 U l–1and to CTR over 0.49. Multivariate statistical analysis showed that five variables are important in discriminating patients suffering from SVTA: age, LAD, LVEF, left ventricular fractional shortening, and CTR. SVTA occurring at discharge from hospital after AMI are indicative of impaired left ventricular pump function.