Monserrat Lorenzo, Elliott Perry M, Gimeno Juan R, Sharma Sanjay, Penas-Lado Manuel, McKenna William J
Service of Cardiology, Juan Canalejo Hospital, A Coruña, Spain.
J Am Coll Cardiol. 2003 Sep 3;42(5):873-9. doi: 10.1016/s0735-1097(03)00827-1.
The aim of this study was to examine the characteristics of non-sustained ventricular tachycardia (NSVT) episodes during Holter monitoring and to determine their relationship to age and prognosis.
It has been suggested that NSVT is only of prognostic importance in patients with hypertrophic cardiomyopathy (HCM) when repetitive, prolonged, or associated with symptoms.
We studied 531 patients with HCM (323 male, 39 +/- 15 years). All underwent ambulatory electrocardiogram monitoring (41 +/- 11 h).
A total of 104 patients (19.6%) had NSVT. The proportion of patients with NSVT increased with age (p = 0.008). Maximum left ventricular wall thickness and left atrial size were greater in patients with NSVT. Mean follow-up was 70 +/- 40 months. Sixty-eight patients died, 32 from sudden cardiac death (SCD). Twenty-one patients received an implantable cardioverter defibrillator (ICD). There were four appropriate ICD discharges. In patients < or =30 years (but not >30), five-year freedom from sudden death was lower in those with NSVT (77.6% [95% confidence interval (CI): 59.8 to 95.4] vs. 94.1% [95% CI: 90.2 to 98.0]; p = 0.003). There was no relation between the duration, frequency, or rate of NSVT runs and prognosis at any age. The odds ratio of sudden death in patients < or =30 years of age with NSVT was 4.35 (95% CI: 1.54 to 12.28; p = 0.006) compared with 2.16 (95% CI: 0.82 to 5.69; p = 0.1) in patients >30 years of age.
Non-sustained ventricular tachycardia is associated with a substantial increase in sudden death risk in young patients with HCM. A relation between the frequency, duration, and rate of NSVT episodes could not be demonstrated.
本研究旨在探讨动态心电图监测期间非持续性室性心动过速（NSVT）发作的特征，并确定其与年龄及预后的关系。
有研究表明，NSVT仅在肥厚型心肌病（HCM）患者中，当发作反复、持续时间长或伴有症状时才具有预后意义。
我们研究了531例HCM患者（男性323例，年龄39±15岁）。所有患者均接受动态心电图监测（41±11小时）。
共有104例患者（19.6%）发生NSVT。发生NSVT的患者比例随年龄增加而升高（p = 0.008）。NSVT患者的最大左心室壁厚度和左心房大小更大。平均随访时间为70±40个月。68例患者死亡，32例死于心源性猝死（SCD）。21例患者接受了植入式心律转复除颤器（ICD）。有4次ICD恰当放电。在年龄≤30岁（而非＞30岁）的患者中，发生NSVT者的5年无猝死生存率较低（77.6%[95%置信区间（CI）：59.8至95.4] vs. 94.1%[95% CI：90.2至98.0]；p = 0.003）。NSVT发作的持续时间、频率或心率与任何年龄的预后均无关联。年龄≤30岁的NSVT患者心源性猝死的比值比为4.35（95% CI：1.54至12.28；p = 0.006），而年龄＞30岁的患者为2.16（95% CI：0.82至5.69；p = 0.1）。
非持续性室性心动过速与年轻HCM患者的心源性猝死风险显著增加相关。未证实NSVT发作的频率、持续时间和心率之间存在关联。
