Fioretti P, Deckers J, Baardman T, Beelen A, ten Katen H J, Brower R W, Simoons M L
Thoraxcenter, Erasmus University, Rotterdam, the Netherlands.
Eur Heart J. 1987 Aug;8 Suppl D:51-4. doi: 10.1093/eurheartj/8.suppl_d.51.
The clinical significance of repetitive ventricular complexes (RVCs) during pre-discharge bicycle ergometry after acute myocardial infarction has been assessed in 408 consecutive patients. RVCs occurred in 32 patients (8%). When compared to patients without RVCs, those with RVCs had a larger infarction, a higher prevalence of heart failure and late sustained ventricular tachycardia or fibrillation, a lower radionuclide ejection fraction and more frequent RVCs during pre-discharge 24-hour electrocardiographic monitoring. During a follow-up 30 patients died, 17 suddenly. Mortality was 15% (N = 5) in patients with RVCs during exercise test and 7% (N = 25) in those without RVCs. Sudden death occurred in only one patient with RVCs. When multivariate analysis was applied to clinical and exercise test data, RVCs during exercise did not predict cardiac mortality independent of variables related to left ventricular function, such as a history of previous myocardial infarction, persistence of heart failure in the late hospital phase and the extent of blood pressure rise during exercise test.
对408例急性心肌梗死后出院前进行踏车运动试验时出现的重复性室性复合波（RVCs）的临床意义进行了评估。32例患者（8%）出现了RVCs。与无RVCs的患者相比，有RVCs的患者梗死面积更大，心力衰竭、晚期持续性室性心动过速或颤动的发生率更高，放射性核素射血分数更低，且出院前24小时心电图监测期间RVCs更频繁。随访期间30例患者死亡，17例猝死。运动试验时有RVCs的患者死亡率为15%（n = 5），无RVCs的患者死亡率为7%（n = 25）。仅1例有RVCs的患者发生猝死。当对临床和运动试验数据进行多变量分析时，运动期间的RVCs并不能独立于与左心室功能相关的变量预测心脏死亡率，这些变量包括既往心肌梗死病史、住院后期心力衰竭的持续存在以及运动试验期间血压升高的程度。
