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JACC：6分钟步行试验可确认ICD治疗无法获益患者

2014-04-15 高晓方 译 医学论坛网

步行ICD胺碘酮
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美国一项研究表明，利用基线6分钟步行试验(SMV)距离小于288米可确认无法从ICD治疗中获益并且胺碘酮治疗有害的亚组患者。论文于4月9日在线发表于《美国心脏病学会杂志》(J Am Coll Cardiol)。 SCD-HeFT试验显示NYHA III级患者未能从ICD中获益并且胺碘酮治疗可能有害，NYHA II级患者则可从ICD中得到显著生存获益，但尚不清楚是否存在更为客观的功能指标。此项研究

美国一项研究表明，利用基线6分钟步行试验(SMV)距离小于288米可确认无法从ICD治疗中获益并且胺碘酮治疗有害的亚组患者。论文于4月9日在线发表于《美国心脏病学会杂志》(J Am Coll Cardiol)。

SCD-HeFT试验显示NYHA III级患者未能从ICD中获益并且胺碘酮治疗可能有害，NYHA II级患者则可从ICD中得到显著生存获益，但尚不清楚是否存在更为客观的功能指标。此项研究在随机化之前对2397例患者实施了SMW。中位随访时间为45.5个月。主要终点为全因死亡率，并在二次分析中评估病因特异性死亡率。

结果显示，在基线SMW距离>386m、288～386m和<288m的情况下，相对于安慰剂的ICD治疗危险比分别为0.42、0.57和1.02。与之相应的相对于安慰剂的胺碘酮危险比分别为0.68、0.86和1.56。SMW距离与心衰相关性死亡率呈负相关，但与心律失常死亡率无关。ICD治疗在SMW中、高三分位患者中可降低心律失常死亡率，但对心衰死亡率无影响。

原始出处：


Daniel P. Fishbein, MD, FACC; Anne S. Hellkamp, MS; Daniel B. Mark, MD, MPH, FACC; Mary Norine Walsh, MD, FACC; Jeanne E. Poole, MD, FACC; Jill Anderson, BSN, RN; George Johnson, BSEE; Kerry L. Lee, PhD; Gust H. Bardy, MD, FACC.Use of the Six-Minute Walk Distance to Identify Variations in Treatment Benefits From ICD and Amiodarone: Results From the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) ONLINE FIRST.J Am Coll Cardiol. 2014;():. doi:10.1016/j.jacc.2014.02.602

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    2015-03-22 JR19860228

    #6分钟步行试验#

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    2014-07-09 yuanming15

    #步行#

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    2014-05-16 hbwxf

    #JACC#

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    2014-07-27 yilong5287542

    #ICD#

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    2014-04-17 12498568m50暂无昵称

    #ACC#

    0

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