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非持续室性心动过速。

Nonsustained ventricular tachycardia.

机构信息

Athens Euroclinic, Athens, Greece.

出版信息

J Am Coll Cardiol. 2012 Nov 13;60(20):1993-2004. doi: 10.1016/j.jacc.2011.12.063. Epub 2012 Oct 17.

Abstract

Nonsustained ventricular tachycardia (NSVT) has been recorded in a wide range of conditions, from apparently healthy individuals to patients with significant heart disease. In the absence of heart disease, the prognostic significance of NSVT is debatable. When detected during exercise, and especially at recovery, NSVT indicates increased cardiovascular mortality within the next decades. In trained athletes, NSVT is considered benign when suppressed by exercise. In patients with non-ST-segment elevation acute coronary syndrome, NSVT occurring beyond 48 h after admission indicates an increased risk of cardiac and sudden death, especially when associated with myocardial ischemia. In acute myocardial infarction, in-hospital NSVT has an adverse prognostic significance when detected beyond the first 13 to 24 h. In patients with prior myocardial infarction treated with reperfusion and beta-blockers, NSVT is not an independent predictor of long-term mortality when other covariates such as left ventricular ejection fraction are taken into account. In patients with hypertrophic cardiomyopathy, and most probably genetic channelopathies, NSVT carries prognostic significance, whereas its independent prognostic ability in ischemic heart failure and dilated cardiomyopathy has not been established. The management of patients with NSVT is aimed at treating the underlying heart disease.

摘要

非持续室性心动过速(NSVT)可发生于多种情况,从看似健康的个体到有严重心脏病的患者。在没有心脏病的情况下,NSVT 的预后意义存在争议。当在运动中检测到,特别是在恢复期检测到 NSVT 时,表明在未来几十年心血管死亡率增加。在训练有素的运动员中,运动抑制的 NSVT 被认为是良性的。在非 ST 段抬高型急性冠状动脉综合征患者中,入院后 48 小时以上出现 NSVT 表明心脏性和猝死风险增加,尤其是当伴有心肌缺血时。在急性心肌梗死中,入院后 13 至 24 小时后检测到的院内 NSVT 具有不良预后意义。在接受再灌注和β受体阻滞剂治疗的既往心肌梗死患者中,当考虑其他协变量(如左心室射血分数)时,NSVT 不是长期死亡率的独立预测因素。在肥厚型心肌病患者中,很可能在遗传性通道病患者中,NSVT 具有预后意义,而在缺血性心力衰竭和扩张型心肌病中,其独立的预后能力尚未确定。NSVT 患者的管理旨在治疗潜在的心脏病。

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