运动能力良好且运动超声心动图结果轻度异常患者的预后：高危亚组的识别。

Prognosis of patients with good exercise capacity and mildly abnormal exercise echocardiography results: identification of an at-risk subgroup.

作者信息

McCully Robert B, Ommen Steve R, Klarich Kyle W, Burger Kelli N, Mahoney Douglas W, Pellikka Patricia A

机构信息

Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.

出版信息

J Am Soc Echocardiogr. 2005 Jun;18(6):644-8. doi: 10.1016/j.echo.2004.10.027.

DOI:10.1016/j.echo.2004.10.027

PMID:15947766

Abstract

BACKGROUND

Patients with good exercise capacity and mildly abnormal exercise echocardiography results have a favorable overall prognosis.

OBJECTIVE

We sought to define subgroups that might be at higher risk.

METHODS

We examined outcomes of 868 patients (women, > or = 5 metabolic equivalents; men, > or = 7 metabolic equivalents) with mild rest- or exercise-induced wall-motion abnormalities and evaluated potential predictors of time to cardiac death or nonfatal myocardial infarction (MI).

RESULTS

Mean age was 64 +/- 10 years; 477 patients (55%) were men. Mean follow-up was 3.1 +/- 1.5 years; cardiac event rate was 1.2% per person-year. A history of MI was the only significant predictor (risk ratio, 3.9; 95% confidence interval, 1.9-7.8; P = .0001), with 1-, 3-, and 5-year event-free survival of 98.5% +/- 1.1%, 92.6% +/- 2.6%, and 83.3% +/- 5.1%, respectively (event rate, 3.4%).

CONCLUSIONS

Patients with a history of MI have a higher annual cardiac event rate and may benefit from reevaluation, whereas no history of MI connotes a favorable prognosis.

摘要

背景

运动能力良好且运动超声心动图结果轻度异常的患者总体预后良好。

目的

我们试图确定可能具有更高风险的亚组。

方法

我们检查了868例静息或运动诱发的轻度室壁运动异常患者（女性，≥5代谢当量；男性，≥7代谢当量）的预后情况，并评估了心脏死亡或非致死性心肌梗死（MI）发生时间的潜在预测因素。

结果

平均年龄为64±10岁；477例患者（55%）为男性。平均随访时间为3.1±1.5年；心脏事件发生率为每人年1.2%。心肌梗死病史是唯一显著的预测因素（风险比，3.9；95%置信区间，1.9 - 7.8；P = .0001），1年、3年和5年无事件生存率分别为98.5%±1.1%、92.6%±2.6%和83.3%±5.1%（事件发生率，3.4%）。