计算法合成右侧胸部心电图导联对肺动脉高压的检测和评价

Detection and evaluation of pulmonary artery hypertension using a calculation method-synthesized right-sided chest ECG lead

目的:评估运用由12导联心电图(ECG)信息所产生的计算法合成右胸ECG(syn-ECG)评价肺动脉高压(PAH)的有效性。方法:选择45例PAH患者的Syn-ECG(PAH组),与45例年龄和性别相当的正常人的Syn-ECG(正常对照组)进行对比分析。结果:肺动脉高压患者Syn-ECG的R波振幅和R/S比值均显著高于正常对照组(P均=0.001)。Pearson相关分析显示,与标准导联V1(r=0.425,P=0.004)相比,Syn-ECG的R波振幅与估测的肺动脉收缩压(PASP)显示了更好的相关性(r=0.509~0.609,P均=0.001)。受试者工作特征曲线表明,在Syn-V5R中,以R波振幅0.125mV为界值[曲线下面积(AUC)=0.802,P=0.001],预测PAH的敏感度为0.622,特异性为0.911;以R/S比值0.405为界值(AUC=0.818,P=0.001),预测PAH敏感度为0.733,特异性为0.867。结论:与标准12导联ECG相比,Syn-ECG提高了诊断肺动脉高压的准确度,为临床评估肺动脉高压提供了简便、有效的方法。

Objective:To assess effectiveness of 12-lead ECG information produced calculation method-synthesized right chest ECG(Syn-ECG)in evaluation of pulmonary artery hypertension(PAH).Methods:Syn-ECG of 45 PAH patients(PAH group)were compared and analyzed with Syn-ECG of 45 healthy subjects with corresponding aged and gender(normal control group).Results:R wave amplitude and R/S ratio of Syn-ECG in PAH group were significantly higher than those of normal control group(P=0.001 all).Pearson correlation analysis indicated that compared with standard lead V1(r=0.425,P=0.004),R wave amplitude of Syn-ECG possessed better correlation with estimated pulmonary artery systolic pressure(PASP)(r=0.509-0.609,P=0.001 all).ROC indicated that in Syn-V5R,with R wave amplitude=0.125mV as cutoff point(AUC=0.802,P=0.001),its sensitivity and specificity was 0.622,0.911 respectively in predicting PAH;with R/S ratio=0.405 as cutoff point(AUC=0.818,P=0.001),its sensitivity and specificity was 0.733,0.867 respectively in predicting PAH.Conclusion:Compared with standard 12-lead ECG,Syn-ECG increases accuracy in diagnosing PAH,provides simple and effective method for assessing PAH in clinic.