Meinertz T, Hofmann T, Zehender M
II. Medizinische Klinik, Allgemeinen Krankenhauses St. Georg, Hamburg.
Z Gesamte Inn Med. 1992 May;47(5):181-8.
Only 30-40% of all victims of sudden cardiac death could so far be classified as risk patients during their lifetime. Risk factors for sudden death have little predictive value in an asymptomatic population: for example, the typical risk profile for the presence of coronary heart disease and changes in the surface-ECG at rest and especially in the surface-ECG under stress. Usually, the victims of sudden cardiac death among top performance athletes have been suffering from a heart disease of which they knew nothing beforehand: below 40 years of age, mostly from hypertrophic cardiomyopathy; beyond 40, predominantly from coronary heart disease. Among the heart diseases, sudden cardiac death is the cause of death most often in hypertrophic cardiomyopathy, in dilatative cardiomyopathy and in certain types of coronary heart disease. Notwithstanding the employment of fully update cardiological diagnostics the risk patients cannot be identified with reliable precision among those suffering from these diseases. It is only clinically manifest persistent ventricular tachycardia or successful reanimation in case of ventricular fibrillation that will definitely pinpoint the patient as being at risk of sudden cardiac death also in the future.
到目前为止，在所有心源性猝死的受害者中，只有30%至40%在其一生中可被归类为高危患者。猝死的危险因素在无症状人群中几乎没有预测价值：例如，冠心病存在的典型风险特征以及静息时体表心电图的变化，尤其是应激状态下的体表心电图变化。通常，顶级职业运动员中心源性猝死的受害者事先对自己所患的心脏病一无所知：40岁以下的大多患有肥厚型心肌病；40岁以上的主要患有冠心病。在心脏病中，心源性猝死最常是肥厚型心肌病、扩张型心肌病和某些类型冠心病的死因。尽管采用了完全更新的心脏病诊断方法，但在患有这些疾病的人群中，仍无法可靠精准地识别出高危患者。只有临床上表现为持续性室性心动过速或在心室颤动情况下成功复苏，才能明确判定该患者未来也有发生心源性猝死的风险。
