Sgueglia Gregory Angelo, Sestito Alfonso, Spinelli Antonella, Cioni Beatrice, Infusino Fabio, Papacci Fabio, Bellocci Fulvio, Meglio Mario, Crea Filippo, Lanza Gaetano Antonio
Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma, Italy.
Heart. 2007 May;93(5):591-7. doi: 10.1136/hrt.2006.102194. Epub 2007 Jan 19.
To assess the long-term effect of spinal cord stimulation (SCS) in patients with refractory cardiac syndrome X (CSX).
A prospective, controlled, long-term follow-up was performed of 19 patients with CSX with refractory angina who underwent SCS (SCS group, 5 men, mean (SD) age 60.9 (8.5) years); 9 comparable patients with CSX who refused SCS treatment (3 men, mean (SD) age 60.9 (8.8) years) constituted the control group. Clinical and functional status were assessed at the time of screening for SCS indication (basal evaluation) and at a median (range) follow-up of 36 (15-82) months.
The two groups at baseline did not show any difference in clinical characteristics and angina status. All indicators of angina status (angina episode frequency, duration and short-acting nitrate use) improved significantly at follow-up in the SCS group (p<0.001) but not in controls. Functional status, as assessed by the Seattle Angina Questionnaire and a visual analogue scale for quality of life, improved at follow-up in the SCS group (p<0.001 for all scales) but not in controls. Exercise tolerance, exercise-induced angina and ST segment changes also significantly improved in the SCS group but not in controls.
Data show that SCS can be a valid form of treatment for long-term control of angina episodes in patients with refractory CSX.
评估脊髓刺激（SCS）对难治性心脏X综合征（CSX）患者的长期疗效。
对19例接受SCS治疗的难治性心绞痛CSX患者进行前瞻性、对照、长期随访（SCS组，5例男性，平均（标准差）年龄60.9（8.5）岁）；9例拒绝SCS治疗的类似CSX患者（3例男性，平均（标准差）年龄60.9（8.8）岁）构成对照组。在筛选SCS适应症时（基础评估）以及在中位（范围）36（15 - 82）个月的随访时评估临床和功能状态。
两组在基线时临床特征和心绞痛状态无差异。SCS组随访时心绞痛状态的所有指标（心绞痛发作频率、持续时间和短效硝酸酯类药物使用）均显著改善（p<0.001），而对照组无改善。通过西雅图心绞痛问卷和生活质量视觉模拟量表评估的功能状态在SCS组随访时有所改善（所有量表p<0.001），而对照组无改善。SCS组的运动耐量、运动诱发心绞痛和ST段改变也显著改善，而对照组无改善。
数据表明，SCS可作为长期控制难治性CSX患者心绞痛发作的有效治疗方式。
