Department of Cardiology, Aga Khan University Hospital, Karachi.
Department of Cardiology, Aga Khan University Hospital, Karachi, Pakistan.
J Pak Med Assoc. 2021 Jul;71(7):1745-1748. doi: 10.47391/JPMA.921.
To evaluate cardiovascular outcomes in patients with normal nuclear myocardial perfusion imaging, but ischaemic electrocardiogram changes during pharmacological or exercise stress tests.
The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of patients who underwent either pharmacological or exercise stress myocardial perfusion scan and had a normal scan with ischaemic electrocardiogram changes between January 2013 and December 2014. All cardiac events, including angina, myocardial infarction, heart failure, coronary revascularisation and cardiac death, as well as non-cardiac deaths were noted. Data was analysed using STATA 14.2.
Of the 2770 patients whose data was initially checked, 296(10.6%) developed ischaemic electrocardiogram changes during the stress test but had normal myocardial perfusion scan. Of them, 181(61%) patients were male, and the overall mean age was 62±15 years. Follow-up data was available for 280(94.5%) of these patients, with a mean follow-up of 48±7 months. Of these patients, 8(2.8%) died, and 1(0.3%) of them died due to inferior wall myocardial infarction. Myocardial infarction was found in 2(0.7%) patients, and 1(0.3%) patient was hospitalised with heart failure. Also, 12(4.3%) patients underwent revascularization for stable angina, 9(3.2%) underwent percutaneous transluminal coronary angioplasty, and 3(1.07%) needed coronary artery bypass grafting.
Ischaemic electrocardiographic changes during stress testing in patients with normal myocardial perfusion scan were not associated with adverse outcomes, and the risk of cardiovascular events was relatively low for an intermediate follow-up period.
评估在药物或运动负荷试验中出现正常核心肌灌注成像但存在缺血性心电图改变的患者的心血管结局。
这是一项回顾性研究，在卡拉奇的 Aga Khan 大学医院进行，纳入了 2013 年 1 月至 2014 年 12 月期间接受药物或运动负荷心肌灌注扫描且扫描正常但心电图存在缺血性改变的患者的数据。记录所有心脏事件，包括心绞痛、心肌梗死、心力衰竭、冠状动脉血运重建和心脏死亡，以及非心脏死亡。使用 STATA 14.2 分析数据。
在最初检查的 2770 名患者中，296 名（10.6%）在应激试验中出现缺血性心电图改变，但心肌灌注扫描正常。其中，181 名（61%）患者为男性，总体平均年龄为 62±15 岁。对其中 280 名（94.5%）患者的随访数据进行了评估，平均随访 48±7 个月。这些患者中，8 名（2.8%）死亡，其中 1 名（0.3%）因下壁心肌梗死死亡。2 名（0.7%）患者发生心肌梗死，1 名（0.3%）患者因心力衰竭住院。此外，12 名（4.3%）患者因稳定性心绞痛进行血运重建，9 名（3.2%）患者行经皮腔内冠状动脉血管成形术，3 名（1.07%）患者需要冠状动脉旁路移植术。
在正常心肌灌注扫描的患者中，应激试验时出现缺血性心电图改变与不良结局无关，且在中期随访期间心血管事件的风险相对较低。
