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Study: Individuals Feel Sex-Specific Symptoms Before Impending Cardiac Arrest
Smidt Heart Institute Investigators Found That 50% of Individuals Experienced Warning Signs Prior to Their Investigators from the Smidt Heart Institute at Cedars-Sinai are one step closer to helping individuals catch a sudden cardiac arrest before it happens, thanks to a study published today in the peer-reviewed journal The Lancet Digital Health.
The study, led by sudden cardiac arrest expert Sumeet Chugh, MD, found that 50% of individuals who experienced a sudden cardiac arrest also experienced a telling symptom 24 hours before their loss of heart function.
Smidt Heart Institute investigators also learned that this warning symptom was different for women than it was for men. For women, the most prominent symptom of an impending sudden cardiac arrest was shortness of breath, whereas men experienced chest pain.
Smaller subgroups of both genders experienced abnormal sweating and seizure-like activity.
Out-of-hospital sudden cardiac arrest claims the lives of 90% of people who experience it, marking an urgent need to better predict—and prevent—the condition.
“Harnessing warning symptoms to perform effective triage for those who need to make a 911 call could lead to early intervention and prevention of imminent death,” said Chugh, director of the Center for Cardiac Arrest Prevention in the Smidt Heart Institute and senior author of the study. “Our findings could lead to a new paradigm for prevention of sudden cardiac death.”
For this study, investigators used two established and ongoing community-based studies, each developed by Chugh: the ongoing Prediction of Sudden Death in Multi-Ethnic Communities (PRESTO) Study in Ventura County, California, and the Oregon Sudden Unexpected Death Study (SUDS), based in Portland, Oregon.
Both studies provide Cedars-Sinai investigators with unique, community-based data to establish how to best predict sudden cardiac arrest.
“It takes a village to do this work,” said Chugh, the Pauline and Harold Price Chair in Cardiac Electrophysiology Research, medical director of the Heart Rhythm Center in the Department of Cardiology, and director of the Division of Artificial Intelligence in Medicine in the Department of Medicine. “We initiated the SUDS study 22 years ago and the PRESTO study eight years ago. These cohorts have provided invaluable lessons along the way. Importantly, none of this work would have been possible without the partnership and support of first responders, medical examiners and the hospital systems that deliver care within these communities.”
In both the Ventura and Oregon studies, Smidt Heart Institute investigators evaluated the prevalence of individual symptoms and sets of symptoms prior to sudden cardiac arrest, then compared these findings to control groups that also sought emergency medical care.
The Ventura-based study showed that 50% of the 823 people who had a sudden cardiac arrest witnessed by a bystander or emergency medicine professional, such as an emergency medicine service (EMS) responder, experienced at least one telltale symptom before their deadly event. The Oregon-based study showed similar results.
“This is the first community-based study to evaluate the association of warning symptoms—or sets of symptoms—with imminent sudden cardiac arrest using a comparison group with EMS-documented symptoms recorded as part of routine emergency care,” said Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute and the Mark Siegel Family Foundation Distinguished Professor.
Such a study, Marbán says, paves the way for additional prospective studies that will combine all symptoms with other features to enhance prediction of imminent sudden cardiac arrest.
“Next we will supplement these key sex-specific warning symptoms with additional features—such as clinical profiles and biometric measures—for improved prediction of sudden cardiac arrest,” said Chugh.
注释：
seizure: n
表示"发作"，means "a sudden occurrence (or recurrence) of a disease"，如：He was released the day after suffering a seizure. 心脏病发作的第二天，他就出院了。
triage: n
表示"分类"，means "sorting and allocating aid on the basis of need for or likely benefit from medical treatment or food"，如：Paramedic Firefighters were assigned responsibilities as Triage Officer and Transportation Officer. 消防队的医护人员被指派为伤检分类人员与运输人员。
imminent: adj
表示" 逼近的；即将发生的"，means "probably about to happen soon"，如：He was faced with imminent death. 他面临逼近的死亡。
paradigm: n
表示" 范例；"，means "a standard or typical example"，如：There's no paradigm to follow in this new industry. 在这个崭新的行业里没有范例可做参考。
prevalence: n
表示"流行；普及"，means "the quality of prevailing generally; being widespread"，如：The prevalence in younger children is not known. 至今不知小年龄儿童的发病率。
biometric: adj
表示"计量生物学的"，如：Biometric authentication is two-phase process. 生物统计身份证实是一个两阶段的过程。
中文简要说明：
最新美国研究发现，50％心脏骤停（Sudden cardiac arrest）患者在发病前24小时，曾出现心脏功能丧失的相关症状，而男性与女性的症状大不相同，女性通常经历呼吸困难症状，男性则是胸痛。
综合英国《每日邮报》（Daily Mail）、洛杉矶「西达斯西奈医学中心」（Cedars-Sinai Medical Center）报导，国际顶尖期刊「刺胳针数字健康」（The Lancet Digital Health）刊登西达斯西奈施密特心脏研究所（Cedars-Sinai Smidt Heart Institute）团队的研究成果。
西达斯西奈施密特心脏研究所心脏骤停专家楚夫（Sumeet Chugh）率领的团队，分析超过1672名加州、俄勒冈州曾发生心脏骤停的患者数据，结果显示，50％患者在发生心脏骤停前24小时，也经历过一次代表心脏功能丧失的症状。
研究进一步发现，男女性患者经历的警示讯号大不相同，多数女性患者出现呼吸困难症状，男性则为胸痛。
除此之外，部分男女患者都曾出现心悸、流汗异常、类癫痫症状、类流感症状。
研究指出，高达90％院外心脏骤停（Out-of-hospital sudden cardiac arrest）患者在发作后丧命，因此预测及及早预防就变得极为迫切。
研究作者楚夫表示，利用警示症状来为患者进行有效分类，能够及早介入并预防死亡，「我们的发现能为预防心脏骤停带来新典范」。
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