A PROGNOSTIC COMPARISON OF ASYMPTOMATIC LEFT-VENTRICULAR HYPERTROPHY AND UNRECOGNIZED MYOCARDIAL-INFARCTION - THE FRAMINGHAM-STUDY
A PROGNOSTIC COMPARISON OF ASYMPTOMATIC LEFT-VENTRICULAR HYPERTROPHY AND UNRECOGNIZED MYOCARDIAL-INFARCTION - THE FRAMINGHAM-STUDY
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DOI：
10.1016/0002-8703(86)90156-0
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发表时间：
1986-02-01
影响因子：
4.8
通讯作者：
ABBOTT, RD
中科院分区：
文献类型：
--
作者：
KANNEL, WB;ABBOTT, RD
在弗雷明翰研究的30年随访中，常规的两年一次的心电图检查显示，315名受试者患有ECG-LVH，164名受试者患有未被识别的心电图-MI，且没有事先对心脏进行解释。在最初没有临床明显冠心病和两种心电异常的受试者中，心电-左室肥厚的发生率大约是心电-心肌梗死的两倍。这两种情况都表现出男性占优势，高血压患者更容易受到这两种情况的影响。在无症状的心脏肥厚和心肌梗死的受试者中，10年年龄调整后的临床冠心病发病率高于普通弗雷明翰样本的发病率。心电-左心室肥厚的发生率几乎与心电-心肌梗死一样大。心力衰竭和中风也更多地发生在有任何一种心电图异常的受试者中，并且心电-左室肥厚的发生率超过心电-心肌梗死的比率。死于冠心病，特别是猝死，也增加了两到四倍，心电-左室肥厚和心电-心肌梗死的风险相似。在女性的心血管死亡中，心电-左心室肥厚的风险比心电-心肌梗死大得多。这些发现表明，在包括冠心病临床表现在内的随后的显性心血管疾病的易感特征和预后方面，心电-左室肥厚和心电-心肌梗死是相似的亚临床事件。
In 30 years of follow-up in the Framingham study, routine biennial ECG examinations revealed 315 subjects with ECG-LVH and 164 with unrecognized ECG-MI without previous cardiac explanation. Among subjects initially free of clinically evident coronary heart disease and both ECG abnormalities, the incidence of ECG-LVH was about double that of ECG-MI. Both events exhibited a male predominance and hypertensive subjects were more vulnerable to each. In subjects with asymptomatic ECG-LVH and ECG-MI, the 10-year, age-adjusted incidence of clinical coronary heart disease was greater than the rate experienced by the general Framingham sample. Rates for ECG-LVH were almost as large as those for ECG-MI. Cardiac failure and stroke also occurred more frequently among subjects with either ECG abnormality, and rates for ECG-LVH exceeded those for ECG-MI. Death from coronary heart disease, and sudden death in particular, was also increased two- to fourfold with similar risks for ECG-LVH and ECG-MI. ECG-LVH carried a significantly greater risk than ECG-MI for cardiovascular deaths in women. These findings suggest that ECG-LVH and ECG-MI are similar subclinical events with respect to predisposing characteristics and prognosis for subsequent overt cardiovascular disease including clinical manifestations of coronary heart disease.