原发性经皮冠状动脉介入治疗后左心室功能对长期预后的重要性。
The importance of left ventricular function for long-term outcome after primary percutaneous coronary intervention.
作者信息
van der Vleuten Pieter A, Rasoul Saman, Huurnink Willem, van der Horst Iwan Cc, Slart Riemer Hja, Reiffers Stoffer, Dierckx Rudi A, Tio René A, Ottervanger Jan Paul, De Boer Menko-Jan, Zijlstra Felix
机构信息
Thoraxcentre, Department of Cardiology, University Medical Centre Groningen, The Netherlands.
出版信息
BMC Cardiovasc Disord. 2008 Feb 23;8:4. doi: 10.1186/1471-2261-8-4.
BACKGROUND
In the present study we sought to determine the long-term prognostic value of left ventricular ejection fraction (LVEF), assessed by planar radionuclide ventriculography (PRV), after ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PPCI).
METHODS
In total 925 patients underwent PRV for LVEF assessment after PPCI for myocardial infarction before discharge from the hospital. PRV was performed with a standard dose of 500 Mbq of 99mTc-pertechnetate. Average follow-up time was 2.5 years.
RESULTS
Mean (+/- SD) age was 60 +/- 12 years. Mean (+/- SD) LVEF was 45.7 +/- 12.2 %. 1 year survival was 97.3 % and 3 year survival was 94.2 %. Killip class, multi vessel-disease, previous cardiovascular events, peak creatin kinase and its MB fraction, age and LVEF proved to be univariate predictors of mortality. When entered in a forward conditional Cox regression model age and LVEF were independent predictors of 1 and 3 year mortality.
CONCLUSION
LVEF assessed by PRV is a powerful independent predictor of long term mortality after PPCI for STEMI.
背景
在本研究中，我们试图确定经皮冠状动脉介入治疗（PPCI）的ST段抬高型心肌梗死（STEMI）患者，通过平面放射性核素心室造影（PRV）评估的左心室射血分数（LVEF）的长期预后价值。
方法
总共925例患者在因心肌梗死接受PPCI治疗出院前接受PRV以评估LVEF。PRV采用500兆贝可的标准剂量99m锝-高锝酸盐进行。平均随访时间为2.5年。
结果
平均（±标准差）年龄为60±12岁。平均（±标准差）LVEF为45.7±12.2%。1年生存率为97.3%，3年生存率为94.2%。Killip分级、多支血管病变、既往心血管事件、肌酸激酶峰值及其MB分数、年龄和LVEF被证明是死亡率的单变量预测因素。当纳入向前条件Cox回归模型时，年龄和LVEF是1年和3年死亡率的独立预测因素。
结论
PRV评估的LVEF是STEMI患者接受PPCI治疗后长期死亡率的有力独立预测因素。
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