静息心电图巨大倒置T波的临床价值

Clinical value of giant negative T wave on resting electrocardiogram

目的探讨静息心电图巨大倒置T波的临床应用价值。方法分析93例一过性和103例持续性巨大倒置T波患者的病因构成、形态、Q-T间期及左心室肥大诸参数。结果一过性巨大倒置T波者主要见于冠心病,尤其是急性冠状动脉综合征和心脏外急症,其形态对称或Q-TC间期未延长者冠心病分别占78.3%和82.0%。持续性巨大倒置T波主要见于各类器质性心脏病,其形态对称且无左心室肥大者冠心病占86.7%。结论对称性倒置或一过性巨大倒置T波对冠心病尤其是急性冠状动脉综合征有预测价值。持续性巨大倒置T波可能是实质性心肌病变的重要预测因素,其形态对称且无左心室肥大时对冠心病尤其是并发实质性心肌病变有预测价值。

Objective To assess clinic value of giant negative T wave (GNT) on resting electrocardiogram. Methods Parameters such as composition of diseases, profile of GNT , Q-T interval and left ventricular hypertrophy on resting ECG were analyzed in 93 patients with transient GNT and 103 patients with permanent GNT. Results Transient GNT was seen mostly in coronary artery disease, especially acute coronary syndrome and non-cardiac emergency events. In patients with symmetric profile or prolonged Q-Tc, coronary artery disease accounted for 78.3% and 82.0%, respectively. Permanent GNT was mainly associated with different organic heart diseases and 86.7% patients with symmetric profile and without left ventricular hypertrophy suffered from coronary artery disease. Conclusion Transient GNT by symmetric profile or prolongation favors presence of coronary artery disease, especially acute coronary syndrome. Permanent GNT probably may be a strong factor predicting organic myocardiosis, and permanent symmetric GNT without left ventricular hypertrophy may indicate coronary artery disease, especially with organic myocardiosis. [