Dagenais G R, Cornaert P, Rouleau J R, Dumesnil J G, Christen A, Marquis Y, Moisan A
Clin Invest Med. 1983;6(4):247-52.
There is evidence that patients with signs of poor left ventricular function or marked ischemia at low work load during an exercise test have a poor prognosis for survival. To determine whether a pacing test can provide similar information, the 6-yr survival rate was computed in 118 medically-treated patients who had undergone a standardized atrial pacing test. Among the 118 patients, 80 had significant coronary artery disease (CAD). The variables measured for the atrial pacing test were: induced angina, myocardial lactate extraction (MLE), maximal heart rate (MHR) and left ventricular end-diastolic pressure (LVEDP) changes. There was no death in 38 patients without significant CAD. The 6-yr survival rate of the 80 patients with CAD was 84 +/- 4% (+/- SEM). Of all the variables, the combinations of MHR less than or equal to 150 beats min-1 during pacing associated with a LVEDP increase greater than or equal to 5 mmHg immediately after pacing or with MLE less than or equal to 0% during pacing constituted the best predictors. Patients with a MHR less than or equal to 150 beats min-1 and a LVEDP increase greater than or equal to 5 mmHg had a 6-yr survival of 56 +/- 12% in comparison to 92 +/- 3% for the remaining patients (P less than 0.001). Patients with a MHR less than or equal to 150 beats min-1 and MLE less than or equal to 0% during pacing had a 6-yr survival of 64 +/- 11% in comparison to 91 +/- 4% for the remaining patients (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
有证据表明，运动试验期间左心室功能不佳或低负荷时出现明显缺血迹象的患者，其生存预后较差。为了确定起搏试验是否能提供类似信息，对118例接受标准化心房起搏试验的药物治疗患者计算了6年生存率。在这118例患者中，80例患有严重冠状动脉疾病（CAD）。心房起搏试验测量的变量包括：诱发心绞痛、心肌乳酸摄取（MLE）、最大心率（MHR）和左心室舒张末期压力（LVEDP）变化。38例无严重CAD的患者无死亡。80例CAD患者的6年生存率为84±4%（±标准误）。在所有变量中，起搏期间MHR≤150次/分钟且起搏后LVEDP升高≥5 mmHg或起搏期间MLE≤0%的组合是最佳预测指标。MHR≤150次/分钟且LVEDP升高≥5 mmHg的患者6年生存率为56±12%，其余患者为92±3%（P<0.001）。起搏期间MHR≤150次/分钟且MLE≤0%的患者6年生存率为64±11%，其余患者为91±4%（P<0.01）。（摘要截断于250字）
