Ability of ambulatory ECG-based T-wave alternans to modify risk assessment of cardiac events: a systematic review.
Ability of ambulatory ECG-based T-wave alternans to modify risk assessment of cardiac events: a systematic review.
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基于动态心电图的 T 波交替改变心脏事件风险评估的能力：系统评价
DOI：
10.1186/1471-2261-14-198
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发表时间：
2014-12-20
影响因子：
2.1
通讯作者：
Zhang CT
中科院分区：
文献类型：
--
作者：
Quan XQ;Zhou HL;Ruan L;Lv JG;Yao JH;Yao F;Huang K;Zhang CT
基于运动的频谱T波交替(TWA)已被认为是一种非侵入性工具，用于识别有心脏性猝死(SCD)和心脏死亡风险的患者。先前的研究表明，基于动态心电图的TWA是一种重要的替代运动平台，可用于心脏事件风险分层。这项研究试图回顾基于24小时动态心电图的TWA的数据，并讨论其在一系列患者风险档案的致命性心脏事件风险分层中的潜在作用。检索1990年1月至2014年11月期间发表的关于基于ACG的TWA的预测价值的前瞻性临床研究。主要终点包括SCD的复合终点、心脏死亡率和严重心律失常事件。数据来自5项研究，共涉及1,588名患者，其中317例TWA阳性，1,271例TWA阴性。与阴性组相比，阳性组SCD发生率(危险比：7.49，95%可信区间：2.65~21.15)、心源性死亡率(HR：4.75，95%CI：0.42~53.55)和综合终点(SCD、心脏死亡、严重心律失常事件，HR：5.94，95%CI：1.80~19.63)均显著增加。在用改进的移动平均法评估TWA的4项研究中，对于复合终点，TWA阳性与阴性的HR为9.51(95%CI：4.99至18.11)。与阴性组相比，基于ACG的TWA阳性组的严重后果风险几乎是阴性组的6倍。因此，基于ACG的TWA为预测致命心脏事件提供了一种准确的手段。本文的在线版本(DOI：10.1186/1471-2261-14-198)包含补充材料，授权用户可以使用。
Exercise-based spectral T-wave alternans (TWA) has been proposed as a noninvasive tool-identifying patients at risk of sudden cardiac death (SCD) and cardiac mortality. Prior studies have indicated that ambulatory electrocardiogram (AECG)-based TWA is an important alternative platform to exercise for risk stratification of cardiac events. This study sought to review data regarding 24-hour AECG-based TWA and to discuss its potential role in risk stratification of fatal cardiac events across a series of patient risk profiles. Prospective clinical studies of the predictive value of AECG-based TWA obtained with daily activity published between January 1990 and November 2014 were retrieved. Major endpoints included composite endpoint of SCD, cardiac mortality, and severe arrhythmic events. Data were accumulated from 5 studies involving a total of 1,588 patients, including 317 positive and 1,271 negative TWA results. Compared with the negative group, positive group showed increased rates of SCD (hazard ratio [HR]: 7.49, 95% confidence interval [CI]: 2.65 to 21.15), cardiac mortality (HR: 4.75, 95% CI: 0.42 to 53.55), and composite endpoint (SCD, cardiac mortality, and severe arrhythmic events, HR: 5.94, 95% CI: 1.80 to 19.63). For the 4 studies evaluating TWA measured using the modified moving average method, the HR associated with a positive versus negative TWA result was 9.51 (95% CI: 4.99 to 18.11) for the composite endpoint. The positive group of AECG-based TWA has a nearly six-fold risk of severe outcomes compared with the negative group. Therefore, AECG-based TWA provides an accurate means of predicting fatal cardiac events. The online version of this article (doi:10.1186/1471-2261-14-198) contains supplementary material, which is available to authorized users.
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DOI：
10.1111/j.1540-8167.2008.01225.x
发表时间：
2008-10-01
影响因子：
2.7
作者：
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通讯作者：
Deedwania, Prakash
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影响因子：
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影响因子：
158.5
作者：
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通讯作者：
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影响因子：
24
作者：
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