Prediction of fatal or near-fatal cardiac arrhythmia events in patients with depressed left ventricular function after an acute myocardial infarction.
Prediction of fatal or near-fatal cardiac arrhythmia events in patients with depressed left ventricular function after an acute myocardial infarction.
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DOI：
10.1093/eurheartj/ehn537
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发表时间：
2009-03
影响因子：
39.3
通讯作者：
Cardiac Arrhythmias and Risk Stratification after Acute Myocardial Infarction study group
中科院分区：
文献类型：
--
作者：
Huikuri HV;Raatikainen MJ;Moerch-Joergensen R;Hartikainen J;Virtanen V;Boland J;Anttonen O;Hoest N;Boersma LV;Platou ES;Messier MD;Bloch-Thomsen PE;Cardiac Arrhythmias and Risk Stratification after Acute Myocardial Infarction study group
目的：探讨危险分层试验能否预测左室射血分数（LVEF）≤ 0.40的急性心肌梗死（AMI）患者发生严重心脏事件。在10个欧洲中心共筛选了5869例连续患者，研究纳入了312例平均LVEF为31 ± 6%的患者（年龄65 ± 11岁）。在AMI后6周进行心率变异性/震荡、周围性心律失常、信号平均心电图（SAECG）、T波电交替和程序电刺激（PES）。主要终点是ECG记录的室颤或症状性持续性室性心动过速（VT）。为了记录这些心电图事件，患者接受了植入式ECG回路记录仪。在2年的随访期间，有25个主要终点（8.0%）。主要终点的最强预测因子是心率变异性指标，例如，经临床变量调整后，极低频成分（<5.7 ln ms 2）减少的风险比（HR）为7.0（95% CI：2.4-20.3，P < 0.001）。PES期间诱导持续性单形性VT（校正HR = 4.8，95% CI，1.7-13.4，P = 0.003）也可预测主要终点。在AMI后LVEF降低的患者中，致死性或接近致死性心律失常可以通过许多危险分层方法预测，特别是通过心率变异性。
To determine whether risk stratification tests can predict serious arrhythmic events after acute myocardial infarction (AMI) in patients with reduced left ventricular ejection fraction (LVEF ≤ 0.40). A total of 5869 consecutive patients were screened in 10 European centres, and 312 patients (age 65 ± 11 years) with a mean LVEF of 31 ± 6% were included in the study. Heart rate variability/turbulence, ambient arrhythmias, signal-averaged electrocardiogram (SAECG), T-wave alternans, and programmed electrical stimulation (PES) were performed 6 weeks after AMI. The primary endpoint was ECG-documented ventricular fibrillation or symptomatic sustained ventricular tachycardia (VT). To document these arrhythmic events, the patients received an implantable ECG loop-recorder. There were 25 primary endpoints (8.0%) during the follow-up of 2 years. The strongest predictors of primary endpoint were measures of heart rate variability, e.g. hazard ratio (HR) for reduced very-low frequency component (<5.7 ln ms2) adjusted for clinical variables was 7.0 (95% CI: 2.4–20.3, P < 0.001). Induction of sustained monomorphic VT during PES (adjusted HR = 4.8, 95% CI, 1.7–13.4, P = 0.003) also predicted the primary endpoint. Fatal or near-fatal arrhythmias can be predicted by many risk stratification methods, especially by heart rate variability, in patients with reduced LVEF after AMI.
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影响因子：
168.9
作者：
Bauer, Axel;Kantelhardt, Jan W.;Schmidt, Georg
通讯作者：
Schmidt, Georg
影响因子：
158.5
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Hohnloser, SH;Kuck, KH;Connolly, SJ
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Connolly, SJ
影响因子：
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Mäkikallio, TH;Barthel, P;Huikuri, HV
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影响因子：
158.5
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通讯作者：
RUSKIN, JN
影响因子：
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作者：
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通讯作者：
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