Zoni Berisso M, Ferroni A, De Caro E, Carratino L, Mela G S, Vecchio C
Eur Heart J. 1986 Sep;7(9):743-8. doi: 10.1093/oxfordjournals.eurheartj.a062135.
160 survivors of acute myocardial infarction (AMI) were evaluated to assess the clinical significance of supraventricular tachyarrhythmias (SVTA) occurring at discharge from the hospital after the acute event. All the variables considered for the study were estimated before hospital discharge; arrhythmias were quantified with a 24 h Holter ECG monitoring system. SVTA occurred in 88 patients (55%). Single or repetitive supraventricular premature beats were found in 65 (41%), paroxysmal atrial or junctional tachycardias in 20 (12%), bouts of atrial flutter or fibrillation in 3 (2%). Bivariate statistical analysis showed no relationship between sex, previous cardiovascular history, type, and location of AMI and SVTA occurrence. A close positive relationship was found between age, left atrial dimension (LAD), cardio-thoracic ratio (CTR) and SVTA occurrence; an inverse relationship was found for left ventricular ejection fraction (LVEF). The presence of SVTA appeared significantly related to age above 55 years, to LAD greater than 40 mm, to LVEF less than 45%, to serum creatine kinase peak levels over 1400 U l-1 and to CTR over 0.49. Multivariate statistical analysis showed that five variables are important in discriminating patients suffering from SVTA: age, LAD, LVEF, left ventricular fractional shortening, and CTR. SVTA occurring at discharge from hospital after AMI are indicative of impaired left ventricular pump function.
对160例急性心肌梗死（AMI）幸存者进行评估，以确定急性事件后出院时发生的室上性快速性心律失常（SVTA）的临床意义。研究中考虑的所有变量均在出院前进行评估；心律失常通过24小时动态心电图监测系统进行量化。88例患者（55%）发生了SVTA。65例（41%）发现单发或反复性室上性早搏，20例（12%）发生阵发性房性或交界性心动过速，3例（2%）发生心房扑动或颤动发作。双变量统计分析显示，性别、既往心血管病史、AMI的类型和部位与SVTA的发生之间无关联。发现年龄、左心房内径（LAD）、心胸比率（CTR）与SVTA的发生呈密切正相关；左心室射血分数（LVEF）呈负相关。SVTA的存在似乎与55岁以上的年龄、LAD大于40mm、LVEF小于45%、血清肌酸激酶峰值水平超过1400U l-1以及CTR超过0.49显著相关。多变量统计分析显示，五个变量对鉴别患有SVTA的患者很重要：年龄、LAD、LVEF、左心室缩短分数和CTR。AMI后出院时发生的SVTA表明左心室泵功能受损。
