Borges-Neto S, Shaw L J, Kesler K, Sell T, Peterson E D, Coleman R E, Jones R H
Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA.
Am J Cardiol. 1997 Apr 1;79(7):851-5. doi: 10.1016/s0002-9149(97)00002-7.
This investigation assesses the prognostic value of radionuclide measurements of cardiac function in patients undergoing coronary artery bypass grafting (CABG). Radionuclide angiograms during exercise and at rest were obtained in 182 patients before (< or = 30 days), early (< or = 3 months), and late (< or = 3 years) after CABG. Cox proportional hazard regression analysis was used to identify independent predictors of 44 cardiac deaths that occurred a median 12 years after bypass. Although the exercise ejection fractions before and early after CABG were significantly related to subsequent cardiac death (chi-square = 10.84, p = 0.001, and chi-square = 7.4, p = 0.006, respectively), the late postoperative exercise ejection fraction was the strongest predictor (chi-square = 13.9, p = 0.0002), contributing above and beyond clinical and catheterization data. These data document the validity of the exercise ejection fraction as an important predictor of cardiac death after CABG and suggest the potential clinical application of serial measurements of the exercise ejection fraction as an important noninvasive adjunct to postoperative evaluation of these patients.
本研究评估了接受冠状动脉旁路移植术（CABG）患者的心脏功能放射性核素测量的预后价值。在182例患者CABG术前（≤30天）、术后早期（≤3个月）和晚期（≤3年）进行了运动和静息状态下的放射性核素血管造影。采用Cox比例风险回归分析来确定旁路术后12年中位数时间内发生的44例心源性死亡的独立预测因素。尽管CABG术前和术后早期的运动射血分数与随后的心源性死亡显著相关（分别为χ² = 10.84，p = 0.001和χ² = 7.4，p = 0.006），但术后晚期运动射血分数是最强的预测因素（χ² = 13.9，p = 0.0002），其作用超过了临床和导管检查数据。这些数据证明了运动射血分数作为CABG术后心源性死亡重要预测指标的有效性，并提示连续测量运动射血分数作为这些患者术后评估重要的非侵入性辅助手段的潜在临床应用价值。
