Baroreflex sensitivity predicts long-term cardiovascular mortality after myocardial infarction even in patients with preserved left ventricular function
Baroreflex sensitivity predicts long-term cardiovascular mortality after myocardial infarction even in patients with preserved left ventricular function
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DOI：
10.1016/j.jacc.2007.08.043
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发表时间：
2007-12-11
影响因子：
24
通讯作者：
Schwartz, Peter J.
中科院分区：
文献类型：
--
作者：
De Ferrari, Gaetano M.;Sanzo, Antonio;Schwartz, Peter J.
目的本研究旨在评估压力反射敏感性（BRS）降低对心肌梗死（MI）后左心室功能正常的患者的长期预测能力。背景MI后的危险分层主要通过识别左心室射血分数（LVEF）降低的患者来进行，因为LVEF降低的患者死亡率更高。自主神经标记物可以帮助细化风险分层。抑郁BRS（35%或以上，年龄65岁）。方法入选244名连续的MI后患者（年龄59 +/-10岁），LVEF >35%（平均54 +/-8%）。他们进行了一个完整的评估，包括BRS 4周后MI。结果在5年的平均随访，14例（5.7%）患者死于心血管原因。多变量分析确定BRS（p = 0.0001），而不是LVEF和年龄，作为心血管死亡率的预测因素。总体人群中抑郁BRS的相对风险（95%置信区间（CI））为11.4（95% CI 3.3 - 39.0），患者为19.6（95% CI 4.1 - 94.8
Objectives This study sought to assess the long-term predictive power of depressed baroreflex sensitivity (BRS) among post-myocardial infarction (MI) patients with preserved left ventricular function.Background Risk stratification after MI is primarily performed by identifying patients with depressed left ventricular ejection fraction (LVEF) because of their greater mortality. Autonomic markers can help refining risk stratification. Depressed BRS (35% or above age 65 years.Methods Two hundred forty-four consecutive post-MI patients (age 59 +/- 10 years) with LVEF >35% (average 54 +/- 8%) were enrolled. They underwent a complete assessment, including BRS 4 weeks after MI.Results During a 5-year mean follow-up, 14 (5.7%) patients died of cardiovascular causes. Multivariate analysis identified BRS (p = 0.0001), but not LVEF and age, as predictive of cardiovascular mortality. The relative risk (95% confidence interval (Cl]) for depressed BRS was 11.4 (95% Cl 3.3 to 39.0) for the overall population, 19.6 (95% Cl 4.1 to 94.8) for patients