INCIDENCE OF ACUTE MYOCARDIAL-INFARCTION IN PATIENTS WITH EXERCISE-INDUCED SILENT-MYOCARDIAL-ISCHEMIA
INCIDENCE OF ACUTE MYOCARDIAL-INFARCTION IN PATIENTS WITH EXERCISE-INDUCED SILENT-MYOCARDIAL-ISCHEMIA
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DOI：
10.1016/0002-9149(87)91155-6
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发表时间：
1987-03-01
影响因子：
2.8
通讯作者：
SPANN, JF
中科院分区：
文献类型：
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作者：
ASSEY, ME;WALTERS, GL;SPANN, JF
55例经血管造影证实的冠状动脉疾病（CAD）患者采用铊-201显像进行了布鲁斯方案运动应激测试。27例患者（I组）表现为心肌灌注不足，无心绞痛，静息时恢复正常；28例患者（II组）表现为可逆性心肌灌注不足，但也有心绞痛。对患者进行了至少30个月的随访。I组有6例患者发生急性心肌梗死（AMI），其中3例死亡，II组只有1例患者发生AMI (p = 0.05)，无死亡。运动应激铊试验中发现的无症状心肌缺血可诱发随后的AMI。以这种方式确定的无症状心肌缺血的存在具有预后价值，独立于血管造影变量，如冠心病程度和左心室射血分数。
Fifty-five patients with angiographically proved coronary artery disease (CAD) underwent Bruce protocol exercise stress testing with thallium-201 imaging. Twenty-seven patients (group I) showed myocardial hypoperfusion without angina pectoris during stress, which normalized at rest, and 28 patients (group II) had a similar pattern of reversible myocardial hypoperfusion but also had angina during stress. Patients were followed for at least 30 months. Six patients in group I had an acute myocardial infarction (AMI), 3 of whom died, and only 1 patient in group II had an AMI (p = 0.05), and did not die. Silent myocardial ischemia uncovered during exercise stress thallium testing may predispose to subsequent AMI. The presence of silent myocardial ischemia identified in this manner is of prognostic value, independent of angiographic variables such as extent of CAD and left ventricular ejection fraction.