冠心病患者QTd变异的心磁图研究

The study of QT dispersion variability in patients with coronary artery disease using magnetocardiography

  • 摘要: 目的: 采用心磁图对健康人,冠心病患者进行心脏复极时间均一性变异的测量,以了解心磁图对冠心病的诊断价值。方法: 对怀疑为冠心病的116例患者,确诊为陈旧性心肌梗死的10例患者和35例健康人的对照组进行心磁图检查,并行普通心电图,负荷心电图,超声心动图,冠状动脉造影检查;心脏复极时间变异的测量采用QT离散度及QT离散度均一性指数(smoothnessindexes,SI),进行心脏复极时间均一性变异的测量。结果: 显示心电图QT离散度的变异不能区分冠心病组与对照组,也不能区分冠心病心肌梗死组与对照组,心磁图QT离散度可区分冠心病心肌梗死组与对照组,离散度均一性修正指数(SIn)可区分冠心病心肌梗死组与对照组,也可区分冠心病组与对照组;冠心病组与对照组比较,QT离散度均一性指数对冠心病诊断的敏感性为78.2%,特异性为81.6%。结论: 心磁图能更好地反映冠心病患者心脏复极时间均一性的变异,优于普通心电图;增加心前区导联的测量及采用QT离散度均一性指数,有助于对冠心病的诊断

     

    Abstract: Objective: The aim of the present study was the temporal and spatial analysis of the QT interval in healthy subjects and in patients suspected coronary artery disease(CAD)using magnetocardiography(MCG)to measurement variability of repolarisation. Methods: Standard 12-lead ECG and 61 channel MCG were performed in 35 healthy subjects;75 patients suspected CAD,35 patients without CAD and 34 patients with CAD and 10 patients with myocardial infarction(MI).For MCG,spatial dispersion was examined by the QT interval value for each channel relative to its position and quantified on the basis of Smoothness Indexes(SI). Results: There was an overall tendency of MCG-QTd and SI values to be higher for the subjects with CAD and MI,MCG-QTd values was better than ECG-QTd,it able to discriminate relevant groups. SI performed better than MCG-QTd;it could significantly discriminate CAD and MI groups from healthy subjects group. Comparison the healthy subjects group to CAD group,we obtain sensitivity of 78.2% and specificity of 81.6% in CAD diagnostically relevant values with SI. Conclusion: MCG-QTd and SI values were higher than ECG-QTd in CAD patients.It suggest that increasing the number of registration sites and examining the spatial inter-lead variability,it may aid in the initial identification of CAD patients from healthy subjects group.

     

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