Arruda A M, McCully R B, Oh J K, Mahoney D W, Seward J B, Pellikka P A
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
Am J Cardiol. 2001 May 1;87(9):1069-73. doi: 10.1016/s0002-9149(01)01463-1.
To assess the prognostic value of exercise echocardiography in patients with prior coronary artery bypass surgery, follow-up was obtained in 718 patients (591 men [82%] and 127 women [18%], aged 67 +/- 9 years) who underwent clinically indicated exercise echocardiography 5.7 +/- 4.7 years after coronary bypass surgery. Resting wall motion abnormalities were present in 479 patients (67%). New or worsening wall motion abnormalities developed with exercise in 366 patients (51%). During a median follow-up of 2.9 years, cardiac events included cardiac death in 36 patients and nonfatal myocardial infarction in 40 patients. The addition of the exercise echocardiographic variables, abnormal left ventricular end-systolic volume response and exercise ejection fraction to the clinical, resting echocardiographic and exercise electrocardiographic model provided incremental information in predicting cardiac events (chi-square 37 to chi-square 42, p = 0.02) and cardiac death (chi-square 38 to chi-square 43, p <0.02). Exercise echocardiography provides prognostic information in patients after coronary artery bypass surgery, incremental to clinical, rest echocardiographic, and exercise electrocardiographic variables.
为评估运动超声心动图对既往接受冠状动脉搭桥手术患者的预后价值，我们对718例患者（591例男性[82%]和127例女性[18%]，年龄67±9岁）进行了随访，这些患者在冠状动脉搭桥手术后5.7±4.7年接受了临床指征的运动超声心动图检查。479例患者（67%）存在静息壁运动异常。366例患者（51%）在运动时出现新的或加重的壁运动异常。在中位随访2.9年期间，心脏事件包括36例心源性死亡和40例非致命性心肌梗死。将运动超声心动图变量、异常左心室收缩末期容积反应和运动射血分数添加到临床、静息超声心动图和运动心电图模型中，在预测心脏事件（卡方值从37增加到42，p = 0.02）和心源性死亡（卡方值从38增加到43，p <0.02）方面提供了增量信息。运动超声心动图为冠状动脉搭桥手术后的患者提供预后信息，补充了临床、静息超声心动图和运动心电图变量。
