A high exercise workload of ≥ 10 METS predicts a low risk of significant ischemia and cardiac events in older adults.
A high exercise workload of ≥ 10 METS predicts a low risk of significant ischemia and cardiac events in older adults.
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DOI：
10.1007/s12350-018-1376-7
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发表时间：
2020-10
期刊：
影响因子：
--
通讯作者：
Bourque JM
中科院分区：
文献类型：
--
作者：
Smith L;Myc L;Watson D;Beller GA;Bourque JM
在运动SPECT心肌灌注成像（MPI）期间达到≥10 METS的患者的显著缺血和主要不良心脏事件（MACE）发生率非常低。目前尚不清楚有多少老年人可以达到≥10 METS，以及低风险是否扩展到该亚组。我们对382例年龄≥65岁接受运动99 mTc SPECT MPI的患者队列进行了研究，包括达到的工作负荷、缺血的患病率和预测因素以及MACE（心源性死亡、非致死性MI、晚期血运重建）。该队列为64.4%的男性，36.9%已知患有冠状动脉疾病（CAD）。所有患者均达到最大年龄预测心率的≥85%。25.4%达到≥10 METS的工作量; 50.3%达到7-9 METS，24.4%达到<7 METS。随着工作负荷的增加，任何缺血和显著缺血（≥10%的左心室（LV））的患病率逐步降低（p=0.037）。达到≥10个METS的患者的LV缺血≥10%的患病率为3.1%（无ST段压低的患者为1.2%）。在中位随访7.0年期间，≥10 METS亚组的心源性死亡和MACE发生率分别为0.6%/年和2.6%/年。接受运动SPECT MPI的相当大比例的老年人可以达到≥10 METS。该亚组的显著LV缺血和MACE发生率较低。在老年人群中实现高工作负荷的有利诊断和预后意义表明，除了某些例外情况，将该亚组纳入基于工作负荷的临时成像策略是可行的。
Patients who achieve ≥10 METS during exercise SPECT myocardial perfusion imaging (MPI) have very low rates of significant ischemia and major adverse cardiac events (MACE). It is unknown how many older adults can achieve ≥10 METS, and if low risk extends to this subgroup. We examined the workload achieved, prevalence and predictors of ischemia, and MACE (cardiac death, nonfatal MI, late revascularization) in a cohort of 382 patients ≥65 years of age who underwent exercise 99mTc SPECT MPI. The cohort was 64.4% male and 36.9% had known coronary artery disease (CAD). All achieved ≥85% of maximum age-predicted heart rate. A workload of ≥10 METS was achieved in 25.4%; 50.3% attained 7–9 METS, and 24.4% reached <7 METS. There was a stepwise decrease in prevalence of any ischemia and significant ischemia (≥10% of the left ventricle (LV)) as workload increased (p=0.037). Patients achieving ≥10 METS had a 3.1% prevalence of ≥10% LV ischemia (1.2% in those without ST depression). Cardiac death and MACE rates in the ≥10 METS subgroup were 0.6%/year and 2.6%/year over a median 7.0 years of follow-up. A substantial proportion of older adults who undergo exercise SPECT MPI can achieve ≥10 METS. This subgroup has low rates of significant LV ischemia and MACE. The favorable diagnostic and prognostic implications of achieving a high workload in an older adult population suggest it is feasible, with certain exceptions, to include this subgroup in workload-based strategies of provisional imaging.
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影响因子：
24
作者：
Bourque, Jamieson M.;Holland, Benjamin H.;Watson, Denny D.;Beller, George A.
通讯作者：
Beller, George A.
DOI：
10.1016/j.jcmg.2015.09.006
发表时间：
2015-11
期刊：
JACC. Cardiovascular imaging
影响因子：
--
作者：
Bourque JM;Beller GA
通讯作者：
Beller GA
DOI：
10.1007/s00259-014-2864-x
发表时间：
2015-02-01
影响因子：
9.1
作者：
Duvall, W. Lane;Savino, John A.;Henzlova, Milena J.
通讯作者：
Henzlova, Milena J.
影响因子：
158.5
作者：
MARK, DB;SHAW, L;PRYOR, DB
通讯作者：
PRYOR, DB
DOI：
10.1016/s0735-1097(02)02164-2
发表时间：
2002-10-16
影响因子：
24
作者：
Gibbons, RJ;Balady, GJ;Smith, SC
通讯作者：
Smith, SC