Tp-Te预测ICD一级预防的有效性

The predictive value of Tp-Te/QRS and Tp-Te/(QT·QRS) in patients with an ICD for primary prevention of SCD

目的探讨Tp-Te/QRS和Tp-Te/(QT·QRS)在心脏性猝死(SCD)一级预防植入埋藏式心脏转复除颤器(ICD)有效性的预测价值。方法通过回顾性分析符合SCD一级预防并植入ICD患者的Tp-Te/QRS和Tp-Te/(QT·QRS)无创检测指标,并通过起搏器程控仪调取起搏器数据,根据是否发生判断正确的心血管事件(室性心动过速或心室颤动)及适当的ICD治疗分两组,对比分析指标在两组间的统计差异程度。结果两组间Tp-Te/QRS和Tp-Te/(QT·QRS)有显著差异(p<0.01)。Tp-Te/QRS和Tp-Te/(QT·QRS)的ROC曲线显示曲线下面积分别为0.789(95%CI 0.667~0.910)和0.733(95%CI 0.585~0.880)。ROC曲线对应的值Tp-Te/QRS≥1.18,敏感性为100%,特异性82%;Tp-Te/(QT·QRS)≥0.0029,敏感性为100%,特异性82%。结论Tp-Te/QRS和Tp-Te/(QT·QRS)在预测SCD一级预防植入ICD的有效性方面有较高的临床应用价值。

Objective To explore the predictive value of Tp-Te/QRS and Tp-Te/(QT·QRS)in patients with an ICD for primary prevention of SCD.Methods This research analysed the noninvasive detection index Tp-Te/QRS and Tp-Te/(QT·QRS)for implanted ICD for primary prevention of SCD through the retrospective analysis.The follow-up data divided into two groups according to whether the correct cardiovascular events(ventricular tachycardia or ventricular fibrillation)and the appropriate ICD therapy.And to analyse the difference of indicators and optimal combination between the two groups.Results Tp-Te/QRS and Tp-Te/(QT·QRS)were significant differences between the two groups.The area under the ROC curve of Tp-Te/QRS and Tp-Te/(QT·QRS)were 0.789(95%CI 0.667~0.910)and 0.733(95%CI 0.585~0.880)respectively.Tp-Te/QRS≥1.18,the sensitivity and specificity are 100%and 82%respectively.Tp-Te/(QT·QRS)≥0.0029,the sensitivity and specificity are 100%and 82%respectively.Conclusions This study results showed there were higher predictive value of Tp-Te/QRS and Tp-Te/(QT·QRS)for implanted ICD for primary prevention of SCD.