应激性心肌病与非ST段抬高型心肌梗死：左心室功能障碍的预测因素
Takotsubo Cardiomyopathy and Non-ST-Segment Elevation Myocardial Infarction: Predictors of Left Ventricular Dysfunction.
作者信息
Hinojos Andrew, Vanhecke Thomas E, Enright Susan, Elg Nathan, Gifft Kristina, Marengo Benjamin, Rao Swati
机构信息
Department of Internal Medicine, Genesys Regional Medical Center/Ascension Health, Grand Blanc, MI, USA.
Cardiovascular Medicine, Genesys Regional Medical Center/Ascension Health, Grand Blanc, MI, USA.
出版信息
Clin Med Insights Cardiol. 2017 Jul 10;11:1179546817716103. doi: 10.1177/1179546817716103. eCollection 2017.
BACKGROUND
Acute coronary syndrome (ACS) from non-ST-segment elevation myocardial infarction (NSTEMI) and Takotsubo (TK) cardiomyopathy present with similar initial clinical features and can result in left ventricular (LV) dysfunction and acute heart failure.
METHODS
This study was a retrospective case-control study that identified patients aged 18 years and older who presented with ACS and underwent cardiac catheterization.
RESULTS
There were a total of 321 patients in the TK group and 1031 patients in the NSTEMI group. There was significantly worse LV dysfunction in the TK group with average ejection fraction (EF) of 44.35% (±15.11%) versus NSTEMI with an average EF of 47.36% (±13.5%) ( < .001). The presence of TK yielded of an odds ratio (OR) of 2.373 (95% confidence interval [CI]: 1.165-3.618) and presence of peripheral artery disease (PAD) yielded an OR of 2.053 (95% CI: 1.165-3.618).
CONCLUSIONS
The presence of TK cardiomyopathy and PAD were independent predictors of patients who had LVEF of <35% and elevated B-type natriuretic peptide levels.
背景
非ST段抬高型心肌梗死（NSTEMI）所致急性冠状动脉综合征（ACS）和应激性心肌病（TK）具有相似的初始临床特征，均可导致左心室（LV）功能障碍和急性心力衰竭。
方法
本研究为一项回顾性病例对照研究，纳入年龄在18岁及以上、表现为ACS并接受心脏导管检查的患者。
结果
TK组共有321例患者，NSTEMI组有1031例患者。TK组的左心室功能障碍明显更严重，平均射血分数（EF）为44.35%（±15.11%），而NSTEMI组的平均EF为47.36%（±13.5%）（P<0.001）。存在TK的比值比（OR）为2.373（95%置信区间[CI]：1.165 - 3.618），存在外周动脉疾病（PAD）的OR为2.053（95%CI：1.165 - 3.618）。
结论
TK心肌病和PAD的存在是左心室射血分数<35%且B型利钠肽水平升高患者的独立预测因素。
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