Dhond M R, Nguyen T, Whitley T B, Donnell K, Bommer W J
Division of Cardiovascular Medicine, Department of Medicine, University of California Davis Medical Center, ACC, Suite 2800, 4860 Y Street, Sacramento, CA 95817, USA.
Echocardiography. 2000 Jul;17(5):429-32. doi: 10.1111/j.1540-8175.2000.tb01158.x.
The aim of this study was to assess the prognostic value of the 12-lead electrocardiogram (ECG) obtained during dobutamine stress echocardiography (DSE) in predicting subsequent cardiac events. We retrospectively analyzed 345 patients undergoing DSE in 1992-1994 and selected those patients with negative echo results for ischemia. Of the 200 patients with negative DSE results, a separate analysis of their ECG data was performed with results reported as either positive, negative, or nondiagnostic for ischemia. Follow-up was performed through a physician chart review and direct telephone contact. Event rates were determined for hard (myocardial infarction or cardiac death) and soft (hospitalization for angina and/or congestive heart failure, coronary angioplasty, or coronary artery bypass graft surgery) cardiac events occurring after the negative DSE for up to 6 years after the test. Death was also determined by referencing the patients' data with mortality data available on the Internet. There were 143 patients with ECG data reported as negative and 40 patients with ECG data reported as positive for ischemia. The hard and soft event rates were 1.5% and 9% per patient per year in the ECG negative group and 2% and 11% in the ECG positive group. There were no statistical differences in event rates between the two groups during the 5-year follow-up period. Our results suggest that the ECG result obtained during DSE does not confer any incremental prognostic value over the echo result.
本研究的目的是评估多巴酚丁胺负荷超声心动图（DSE）期间获得的12导联心电图（ECG）在预测后续心脏事件方面的预后价值。我们回顾性分析了1992年至1994年期间接受DSE的345例患者，并选择了那些超声心动图缺血结果为阴性的患者。在200例DSE结果为阴性的患者中，对其心电图数据进行了单独分析，结果报告为缺血阳性、阴性或无法诊断。通过医生病历审查和直接电话联系进行随访。确定了在DSE阴性后长达6年的时间里发生的严重（心肌梗死或心源性死亡）和轻微（因心绞痛和/或充血性心力衰竭住院、冠状动脉成形术或冠状动脉搭桥手术）心脏事件的发生率。死亡情况也通过将患者数据与互联网上可获得的死亡率数据进行比对来确定。有143例患者的心电图数据报告为缺血阴性，40例患者的心电图数据报告为缺血阳性。心电图阴性组每位患者每年的严重和轻微事件发生率分别为1.5%和9%，心电图阳性组分别为2%和11%。在5年的随访期内，两组之间的事件发生率没有统计学差异。我们的结果表明，DSE期间获得的心电图结果相对于超声心动图结果没有任何额外的预后价值。
