Minardi G, Boccardi L, Pennestri F, Tanzi P, Ghilardi P, Bianconi L, Rulli V
G Ital Cardiol. 1981;11(8):1063-71.
The Authors have examined the possibility for diagnostic and prognostic value of exercise stress test and of dynamic ecg in the identification of ventricular ectopic activity which represent a factor risk of sudden death. 41 male patients with IHD and Myocardial Infarction were given exercise stress test and Holter monitoring according to the usual methods. Both methods were useful to identify Pts with arrhythmias. The total incidence of ventricular ectopic beats was 78% with Holter and 46% with exercise test. Holter monitoring showed a major possibility to detect high degree arrhythmias (39%) against 9% of exercise test. Two methods are not comparable, not it was possible to demonstrate statistically significant incidence of ventricular ectopics with respect to the localization of M.I. 90% of Pts with positive exercise test (angina and/or ecg alterations) showed ventricular ectopic beats against 45% of Pts with negative exercise test. The association of ventricular ectopic beats in Holter and positive response to exercise test is highly predictable of sudden death. The results of investigation suggest the opportunity to evaluate Pts with MI by both methods, dynamic ecg and exercise stress test.
作者们研究了运动应激试验和动态心电图在识别室性异位活动方面的诊断和预后价值,室性异位活动是猝死的一个危险因素。41例患有缺血性心脏病和心肌梗死的男性患者按照常规方法进行了运动应激试验和动态心电图监测。两种方法对于识别心律失常患者均有用。动态心电图监测显示室性早搏的总发生率为78%,运动试验为46%。动态心电图监测显示检测到高度心律失常的可能性更大(39%),而运动试验为9%。两种方法不可比,无法从统计学上证明室性早搏的发生率与心肌梗死的部位有关。运动试验阳性(心绞痛和/或心电图改变)的患者中有90%出现室性早搏,而运动试验阴性的患者中这一比例为45%。动态心电图监测中室性早搏与运动试验阳性反应的关联对猝死具有高度预测性。研究结果表明,有必要通过动态心电图和运动应激试验这两种方法对心肌梗死患者进行评估。