急性心筋梗塞患者の長期予後予測における加算平均心電図の有用性

概要

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Late potential (LP) measured by signal averaged electrocardiography (SAECG) is an established predictor of ventricular tachycardia and sudden cardiac death in patients with cardiomyopathy or old myocardial infarction. However, the usefulness of SAECG in predicting long-term outcomes of patients with acute myocardial infarction (AMI) remains unclear. Therefore, we examined the ability of SAECG to predict long-term outcomes in 68 of 478 consecutive patients with AMI who were admitted to our hospital between 1990 and 1993. The LP was positive in 18 patients. We assessed the incidence of major adverse cardiac events (MACE) including cardiac death, critical ventricular tachycardia requiring an implantable cardioverter-defibrillator or the administration of amiodarone over a mean follow-up period of 9.5 ± 4.0 years. Although the left ventricular ejection fraction was equivalent between the groups, isosorbide dinitrate or diuretics were administered more frequently, and the incidence of MACE was significantly higher (33 vs 10%, p<0.05) in the LP positive, than negative group. Kaplan Meier analysis revealed significant diversion of the event-free survival curve at 5 years from the onset of AMI. Assessing LP using SAECG can apparently help to predict the long-term outcome of patients with AMI.
東京女子医科大学の論文