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首页> 外文期刊>The American Journal of Cardiology >Usefulness of the Integrated Scoring Model of Treadmill Tests to Predict Myocardial Ischemia and Silent Myocardial Ischemia in Community-Dwelling Adults (from the Rancho Bernardo Study)
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Usefulness of the Integrated Scoring Model of Treadmill Tests to Predict Myocardial Ischemia and Silent Myocardial Ischemia in Community-Dwelling Adults (from the Rancho Bernardo Study)

机译：跑步机测试综合评分模型对社区成年人的心肌缺血和沉默性心肌缺血的预测作用（来自兰乔·伯纳多研究）

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摘要

To investigate the association between analyses of submaximal treadmill exercise test (TMT) and long-term myocardial ischemia (Mis) and silent Mis in community-dwelling older adults, 898 Rancho Bernardo Study participants (mean age 55 years) without coronary heart disease underwent TMT and were followed up to 27 years. The main outcome measures are incidence of Mis and silent Mis. During follow-up, 97 Mis and 103 silent Mis events occurred. We measured ST change, inability to achieve target heart rate, abnormal heart rate recovery (HER), and chronotropic incompetence (ChI). Each parameter was a significant predictor for,Mis and silent Mis. An integrated scoring model was based on these 4 parameters and defined as sum of numbers of abnormal parameters. After multiple adjustments, an integrated scoring model independently predicted Mis and silent Mis. The incidence rates of abnormalities of parameters are 36.5% for 1 abnormality, 9.1% for 2 abnormalities, and 2.0% for 3 or 4 abnormalities. Compared with those with normal results, participants with 1 or 2 abnormalities had significantly increased risk for Mis (hazard ratio [HR] 1.79 or 2.34, respectively) and silent Mis (HR 1.80 or 2.64, respectively). Participants with 3 or more positive findings showed an even greater risk for Mis (HR 7.96 [3.02 to 21.00]) and silent Mis (BR 3.22 [0.76 to 13.60]). In conclusion, ST change, ChI, abnormal HRR, inability to achieve target heart rate, and integrated scoring model of TMT were independent predictors of long-term Mis and silent Mis in an asymptomatic middle-aged population. Management of ChI or abnormal HRR in an asymptomatic population may prevent future ischemic heart disease and thus improve the quality of life. (C) 2015 Elsevier Inc. All rights reserved.
机译：为了研究亚最大跑步机运动测试（TMT）与社区居民老年人的长期心肌缺血（Mis）和沉默Mis的分析之间的关联，对898位没有冠心病的Rancho Bernardo研究参与者（平均年龄55岁）进行了TMT并随访了27年。主要结果指标是误传和沉默误传的发生率。在随访期间，发生了97次Mis事件和103次静默Mis事件。我们测量了ST变化，无法达到目标心率，异常心率恢复（HER）和变时能力（ChI）。每个参数都是Mis和Silent Mis的重要预测指标。综合评分模型基于这四个参数，并定义为异常参数数量的总和。经过多次调整后，一个综合评分模型可以独立预测Mis和无声Mis。参数异常的发生率：1个异常的发生率为36.5％，2个异常的发生率为9.1％，3或4个异常的发生率为2.0％。与具有正常结果的参与者相比，具有1或2个异常的参与者的Mis风险（危险比[HR]分别为1.79或2.34）和无声Mis（HR分别为1.80或2.64）显着增加。参与者获得3个或更多阳性结果的人，其误诊（HR 7.96 [3.02至21.00]）和无声误诊（BR 3.22 [0.76至13.60]）的风险更高。总之，ST改变，ChI，HRR异常，无法达到目标心率以及TMT的综合评分模型是无症状中年人群长期Mis和沉默Mis的独立预测因子。在无症状人群中管理ChI或异常HRR可以预防将来的缺血性心脏病，从而改善生活质量。 （C）2015 Elsevier Inc.保留所有权利。

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