PROGNOSTIC IMPLICATIONS OF 'SILENT' VS SYMPTOMATIC MYOCARDIAL ISCHEMIA

“无症状”心肌缺血与有症状心肌缺血的预后意义

• 批准号: 3966713
• 负责人: R O BONOW
• 金额: --
• 依托单位: NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3966713
• 关键词: coronary disorder; disease /disorder classification; exercise; heart disorder diagnosis; heart function; heart imaging /visualization /scanning; human subject; myocardial ischemia /hypoxia; prognosis; radionuclide diagnosis; sign /symptom; sudden cardiac death

Exercise-induced ischemia in mildly symptomatic patients with coronary artery disease identifies a subgroup with a high likelihood of left main disease, 3-vessel disease, and sudden death during subsequent therapy. Many such patients have no chest pain during exercise despite objective evidence of ischemia. To determine the prognostic implications of "silent" ischemia with exercise, we studied 131 consecutive patients with mild or no symptoms and with preserved resting left ventricular function by exercise ECG and radionuclide angiography. Patients developing angina with exercise had a greater prevalence and severity of reversible myocardial ischemia. However, those patients manifesting an ischemic response to stress had similar prevalence of left main or 3-vessel disease and a similar mortality rate during medical therapy whether or not chest pain developed with exercise. Thus, the prognosis in patients with "silent" vs symptomatic ischemia during exercise testing is similar.

轻度症状冠心病患者运动性缺血的研究