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首页> 外文期刊>The American Journal of Cardiology >Prognostic significance of QRS duration in patients with suspected coronary artery disease referred for noninvasive evaluation of myocardial ischemia.
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Prognostic significance of QRS duration in patients with suspected coronary artery disease referred for noninvasive evaluation of myocardial ischemia.

机译：QRS持续时间对疑似冠状动脉疾病的患者的预后意义，可用于无创评估心肌缺血。

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The purpose of this study was to evaluate the prognostic significance of QRS duration in patients with suspected coronary artery disease (CAD) referred for noninvasive evaluation of myocardial ischemia by dobutamine stress echocardiography. QRS duration is a prognostic marker in patients with previous myocardial infarction and/or heart failure. The relation between QRS duration and outcome of patients without known heart disease has not been evaluated. A total of 1,227 patients (707 men, mean age 61 +/- 14 years) with suspected CAD underwent dobutamine stress echocardiography for evaluation of myocardial ischemia. Patients were followed to determine predictors of cardiac events and to assess the incremental significance of QRS duration compared to clinical and dobutamine stress echocardiographic data. During a mean follow-up of 4.2 +/- 2.4 years, 280 patients (23%) died (129 cardiac deaths), and 60 (5%) had a nonfatal infarction. Annualized cardiac death rates were 2.0% in patients with QRS duration <120 ms and 4.4% in patients with QRS duration >or=120 ms, respectively (p <0.0001). Annualized event rates for cardiac deathonfatal infarction were 2.8% in patients with QRS duration <120 ms and 4.8% in patients with QRS duration >or=120 ms (p = 0.0001). Multivariate models identified age, male gender, smoking, QRS duration >or=120 ms, and an abnormal dobutamine stress echocardiogram as independent predictors of cardiac death and the combined end point cardiac deathonfatal infarction. In conclusion, QRS duration is an independent predictor of cardiac death and cardiac deathonfatal infarction in patients with suspected CAD. This risk is persistent after adjustment for clinical variables, left ventricular function, and myocardial ischemia.
机译：这项研究的目的是评估QRS持续时间在多巴酚丁胺负荷超声心动图用于无创评估心肌缺血的可疑冠状动脉疾病（CAD）患者中的预后意义。 QRS持续时间是先前有心肌梗塞和/或心力衰竭的患者的预后指标。 QRS持续时间与无已知心脏病患者预后之间的关系尚未评估。总共1,227例疑似CAD患者（707名男性，平均年龄61 +/- 14岁）接受了多巴酚丁胺负荷超声心动图检查，以评估心肌缺血。跟踪患者以确定心脏事件的预测指标，并评估与临床和多巴酚丁胺负荷超声心动图数据相比QRS持续时间的增量意义。在4.2 +/- 2.4年的平均随访期间，有280例患者（23％）死亡（129例心脏死亡），而60例（5％）患有非致命性梗塞。 QRS持续时间<120 ms的患者的年平均心脏死亡率分别为2.0％和QRS持续时间>或= 120 ms的患者的4.4％（p <0.0001）。 QRS持续时间<120 ms的患者的心源性死亡/非致命性梗塞的年事件发生率为2.8％，QRS持续时间>或= 120 ms的患者为4.8％（p = 0.0001）。多元模型将年龄，男性，吸烟，QRS持续时间≥120ms以及多巴酚丁胺负荷超声心动图异常确定为心源性死亡和合并终点的心源性死亡/非致命性梗死的独立预测因子。总之，QRS持续时间是可疑CAD患者心源性死亡和心源性死亡/非致命性梗死的独立预测因子。在调整了临床变量，左心室功能和心肌缺血后，这种风险仍然存在。

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