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Titolo:
NONINVASIVE RISK MODELING AFTER MYOCARDIAL-INFARCTION
Autore:
REINHARDT L; MAKIJARVI M; FETSCH T; SCHULTE G; SIERRA G; MARTINEZRUBIO A; MONTONEN J; KATILA T; BORGGREFE M; BREITHARDT G;
Indirizzi:
UNIV MUNSTER,MED KLIN & POLIKLIN INNERE MED C KARDIOL & ANGIOL D-48129 MUNSTER GERMANY HOSP WESFAL WILHELMS UNIV,DEPT CARDIOL & ANGIOL MUNSTER GERMANY HOSP WESFAL WILHELMS UNIV,INST ARTERIOSCLEROSIS RES MUNSTER GERMANY HELSINKI UNIV TECHNOL,DEPT TECH PHYS,BIOMED ENGN LAB HELSINKI FINLAND
Titolo Testata:
The American journal of cardiology
fascicolo: 6, volume: 78, anno: 1996,
pagine: 627 - 632
SICI:
0002-9149(1996)78:6<627:NRMAM>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
HEART-RATE-VARIABILITY; SIGNAL-AVERAGED ELECTROCARDIOGRAM; VENTRICULAR LATE POTENTIALS; ARRHYTHMIC EVENTS; PROGNOSTIC-SIGNIFICANCE; TACHYCARDIA; VARIABLES; PREDICTION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
25
Recensione:
Indirizzi per estratti:
Citazione:
L. Reinhardt et al., "NONINVASIVE RISK MODELING AFTER MYOCARDIAL-INFARCTION", The American journal of cardiology, 78(6), 1996, pp. 627-632

Abstract

The aim of this study was to extract and combine noninvasive risk parameters from the signal-averaged electrocardiogram (SAECG) and heart rate variability (HRV) based on 24-hour ambulatory electrocardiography to optimize the prognostic value for arrhythmic events after acute myocardial infarction. A prospective series of 553 men <66 years of age enrolled in the Post-Infarction Late Potential study were analyzed. Within 2 to 4 weeks after acute myocardial infarction, all patients underwent SAECG and 24-hour ambulatory electrocardiography before hospital discharge. During 6 months of followup, 25 patients (4.5%) experiencedarrhythmic events (sustained ventricular tachycardia, n = 11; ventricular fibrillation, n = 7; sudden cardiac death, n = 7). The predictivepower of SAECG and HRV parameters was assessed using a Cox proportional-hazards model. In HRV analysis, the most significant differences between patients with and without arrhythmic events were observed for the beat-to-beat parameter root-mean-square of successive RR differences[RMSSD]): 25.7 +/- 16.9 ms in patients with arrhythmic events versus 34.1 +/- 18.6 ms in patients free of arrhythmic events (p = 0.004). Time domain analysis of the SAECG showed the QRS duration to be most significantly different in both patient groups: 106.4 +/- 18.7 ms (arrhythmic events) versus 95.3 +/- 18.7 ms (no arrhythmic events) (p = 0.001). Based on the Cox regression model, RMSSD and QRS duration were demonstrated to be independent significant risk factors (regression coefficient for QRS duration: c(q) = 0.014 +/- 0.006 ms(-1), p = 0.014; for RMSSD: c(r) = -0.041 +/- 0.016 ms(-1), p = 0.009). Based on the regression coefficients, an analytic risk model was developed describing thearrhythmic risk as a function of QRS duration, RMSSD, and time after infarction. We conclude that the combination of beat-to-bear changes of heart rare measured by RMSSD and QRS duration from the SAECG enhances noninvasive risk stratification after myocardial infarction.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/09/20 alle ore 13:02:56