Prediction of long-term outcomes by signal-averaged electrocardiography in patients with unsustained ventricular tachycardia, coronary artery disease, and left ventricular dysfunction
Prediction of long-term outcomes by signal-averaged electrocardiography in patients with unsustained ventricular tachycardia, coronary artery disease, and left ventricular dysfunction
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DOI：
10.1161/hc2901.093197
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发表时间：
2001-07-24
期刊：
影响因子：
37.8
通讯作者：
Hafley, GE
中科院分区：
文献类型：
--
作者：
Gomes, JA;Cain, ME;Hafley, GE
背景-异常信号平均心电图（SAF-CG）是心肌梗死后持续性室性心动过速基质的无创标志物。我们评估了其对无症状、不持续室性心动过速、冠状动脉疾病和左心室功能障碍患者的预后能力。方法和结果——盲法核心实验室分析了一项多中心试验中 1925 名患者的 SAECG 描记。 Cox 比例风险模型用于检查 SAECG 变量与心律失常、死亡或心脏骤停（主要终点）、心源性死亡和总死亡率之间的个体和联合关系。我们还评估了 SAECG 在不同射血分数 (EF) 水平下的预后效用。过滤后的 QRS 时限 > 114 英寸（SAECG 异常）独立预测主要终点和心源性死亡，与临床变量、心律转复除颤器植入和抗心律失常药物治疗无关。 SAECG异常时，主要终点的5年发生率（28% vs 17%，P=0.0001）、心源性死亡（37% vs 25%，P=0.0001）和总死亡率（43% vs 35%，P=0.0001）显着较高。 EF的组合
Background-An abnormal signal-averaged ECG (SAF-CG) is a noninvasive marker of the substrate of sustained ventricular tachycardia after myocardial infarction. We assessed its prognostic ability in patients with asymptomatic unsustained ventricular tachycardia, coronary artery disease, and left ventricular dysfunction.Methods and Results-A blinded core laboratory analyzed SAECG tracings from 1925 patients in a multicenter trial. Cox proportional hazards modeling was used to examine individual and joint relations between SAECG variables and arrhythmic, death or cardiac arrest (primary end point), cardiac death, and total mortality. We also assessed the prognostic utility of SAECG at different levels of ejection fraction (EF). A filtered QRS duration > 114 ins (abnormal SAECG) independently predicted the primary end point and cardiac death, independent of clinical variables, cardioverter-defibrillator implantation, and antiarrhythmic drug therapy. With an abnormal SAECG, the 5-year rates of the primary end point (28% versus 17%, P=0.0001), cardiac death (37% versus 25%, P=0.0001), and total mortality (43% versus 35%, P=0.0001) were significantly higher. The combination of EF