Wiesfeld A C, Crijns H J, Van den Broek S A, Landsman M L, Hillege H L, van Gilst W H, Lie K I
Department of Cardiology, University Hospital Groningen, The Netherlands.
Coron Artery Dis. 1996 Mar;7(3):225-30.
Sixty-nine patients with sustained ventricular tachyarrhythmias were followed up to evaluate the predictive value of functional capacity (i.e., New York Heart Association class and peak oxygen consumption) and resting left ventricular function (i.e. radionuclide left ventricular ejection fraction, angiographic left ventricular wall motion score and echocardiographic dimensions) with respect to arrhythmia recurrence.
During a mean follow-up of 19 months 18 patients (26%) had an arrhythmia recurrence. Parameters of functional capacity and echocardiographic dimensions were not related to arrhythmia recurrence. Left ventricular ejection fraction and wall motion score were worse in patients with a recurrence compared with the arrhythmia-free patients: 30 +/- 16% versus 40 +/- 19% (mean +/- SD, P = 0.035) and 25 +/- 7 versus 20 +/- 7 (P = 0.01), respectively. Multivariately the most powerful parameter was left ventricular wall motion score (odds ratio 1.12, 95% Cl 1.02-1.23).
Arrhythmia recurrence in ventricular tachyarrhythmia patients relates to resting left ventricular function and not to functional capacity. Since angiographic left ventricular wall motion score is prognostically more important than ejection fraction this parameter should be considered for risk stratification in these patients.
对69例持续性室性心律失常患者进行随访，以评估心功能（即纽约心脏协会分级和峰值耗氧量）和静息左心室功能（即放射性核素左心室射血分数、血管造影左心室壁运动评分和超声心动图测量值）对心律失常复发的预测价值。
在平均19个月的随访期间，18例患者（26%）出现心律失常复发。心功能参数和超声心动图测量值与心律失常复发无关。与无心律失常复发的患者相比，复发患者的左心室射血分数和壁运动评分更差：分别为30±16%对40±19%（平均值±标准差，P = 0.035）和25±7对20±7（P = 0.01）。多因素分析中，最具预测力的参数是左心室壁运动评分（优势比1.12，95%可信区间1.02 - 1.23）。
室性心律失常患者的心律失常复发与静息左心室功能有关，而与心功能无关。由于血管造影左心室壁运动评分在预后方面比射血分数更重要，因此在对这些患者进行危险分层时应考虑该参数。
